Expert review -: Treating an uncomplicated form of Plasmodium falciparum malaria in adults

This article reviews current strategies used in the treatment of uncomplicated forms of malaria due to Plasmodium falciparum. A comprehensive search in selected medical databases (Medline, Pascal, and Embase) was performed on publications containing specific key words (P. falciparum, uncomplicated malaria, halofantrine, mefloquine, quinine, amodiaquine, sulfadoxine, pyrimethamine, and atovaquone). Only relevant review articles, randomized controlled therapeutic trials, and open trials written in English or French were selected. Most publications dealt with drug therapy against chemoresistant strains of P. falciparum in immune and semi-immune individuals, while some discussed antimalarial treatment in nonimmune subjects. Search results indicated that first-line antimalarial agents included halofantrine, mefloquine, and quinine, alone or in combination with tetracycline antibiotics. Criteria for choosing a particular drug included toxicity, contraindications, and geographical origin of the patient. The presence of any single severe clinical or biological symptom made hospitalization mandatory. (C) 1999 Editions scientifiques et medicales Elsevier SAS.