Artesunate with mefloquine at various intervals for non-severe Plasmodium falciparum malaria

被引:8
作者
Hung, LQ
De Vries, PJ
Binh, TQ
Giao, PT
Nam, NV
Holman, R
Kager, PA
机构
[1] Univ Amsterdam, Acad Med Ctr, Div Infect Dis Trop Med & AIDS, NL-1100 DE Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol & Biostat, NL-1100 DE Amsterdam, Netherlands
[3] Cho Ray Hosp, Dept Trop Dis, Chi Minh City, Vietnam
[4] Binh Thuan Provincial Malaria Ctr, Phan Thiet, Binh Thuan Prov, Vietnam
关键词
D O I
10.4269/ajtmh.2004.71.160
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
To study the efficacy, tolerance, population pharmacokinetics and pharmacodynamics of artesunate followed by mefloquine at various intervals, 360 patients with Plasmodium falciparum malaria received 4 mg/kg of artesunate and thereafter 15 mg/kg of mefloquine simultaneously (group A), after 8 hours (after group B), and after 24 hours (group C). Three dosages were completed with placebo. Follow-up was 28 days. All patients recovered rapidly except one case of failure within the first 24 hours. Mefloquine pharmacokinetics was similar in the three regimens. Parasites reappeared in 26%, 26%, and 33% of the patients in groups A, B, and C, respectively. Early recrudescence was associated with high initial parasite density, slow parasite clearance, and rapid mefloquine clearance and low plasma concentrations at day 28. Mefloquine plasma concentrations all reached therapeutic ranges, suggesting reduced parasite sensitivity. In conclusion, there is no interaction between artesunate and mefloquine with respect to tolerance, efficacy, and pharmacokinetics. Single-dose combination therapy with artemisinin drugs and 15 mg/kg of mefloquine does not completely prevent parasite recurrence and may not prevent mefloquine resistance.
引用
收藏
页码:160 / 166
页数:7
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