Artesunate/mefloquine treatment of multi-drug resistant falciparum malaria.
On the western border of Thailand, in an area endemic for multi-drug resistant Plasmodium falciparum malaria, therapeutic responses were assessed in 1967 patients with uncomplicated falciparum malaria treated with 3 d of artesunate (total dose 12 mg/kg) plus mefloquine (total dose 25 mg/kg). The reg...
| Main Authors: | , , , , , , |
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| Formato: | Journal article |
| Idioma: | English |
| Publicado: |
1997
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| _version_ | 1826273615260155904 |
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| author | Price, R Nosten, F Luxemburger, C van Vugt, M Phaipun, L Chongsuphajaisiddhi, T White, N |
| author_facet | Price, R Nosten, F Luxemburger, C van Vugt, M Phaipun, L Chongsuphajaisiddhi, T White, N |
| author_sort | Price, R |
| collection | OXFORD |
| description | On the western border of Thailand, in an area endemic for multi-drug resistant Plasmodium falciparum malaria, therapeutic responses were assessed in 1967 patients with uncomplicated falciparum malaria treated with 3 d of artesunate (total dose 12 mg/kg) plus mefloquine (total dose 25 mg/kg). The regimen was well tolerated and resulted in a rapid clinical response; within 48 h, 96% of patients were aparasitaemic and 94% were afebrile. After correcting for reinfections, the cure rate by day 42 was 89% (95% confidence interval [95% CI] 87-91%). Three independent factors were found to predict recrudescence: age < 14 years (adjusted hazards ratio [AHR] = 1.6, 95% CI 1.1-2.3), initial parasitaemia greater than > 40,000/microL (AHR = 1.6, 95%, CI 1.2-2.2), and pure P. falciparum infections (AHR = 1.8, 95% CI 1.3-2.7). These 3 factors combined accounted for 62% of all treatment failures. Patients who received mefloquine on admission with a high admission parasitaemia (> 40,000/microL) had a three-fold (95% CI 1.3-7) risk of subsequent recrudescence compared with those who received their mefloquine on the second or third day (P = 0.01). There has been no decline in the efficacy of the 3 d artesunate plus mefloquine regimen since it was introduced in 1992. This regimen is safe, well tolerated, and highly effective in the treatment of multi-drug resistant falciparum malaria. |
| first_indexed | 2024-03-06T22:30:53Z |
| format | Journal article |
| id | oxford-uuid:583c7d09-ed90-4f7c-b67b-81af6dcf19eb |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:30:53Z |
| publishDate | 1997 |
| record_format | dspace |
| spelling | oxford-uuid:583c7d09-ed90-4f7c-b67b-81af6dcf19eb2022-03-26T17:01:57ZArtesunate/mefloquine treatment of multi-drug resistant falciparum malaria.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:583c7d09-ed90-4f7c-b67b-81af6dcf19ebEnglishSymplectic Elements at Oxford1997Price, RNosten, FLuxemburger, Cvan Vugt, MPhaipun, LChongsuphajaisiddhi, TWhite, NOn the western border of Thailand, in an area endemic for multi-drug resistant Plasmodium falciparum malaria, therapeutic responses were assessed in 1967 patients with uncomplicated falciparum malaria treated with 3 d of artesunate (total dose 12 mg/kg) plus mefloquine (total dose 25 mg/kg). The regimen was well tolerated and resulted in a rapid clinical response; within 48 h, 96% of patients were aparasitaemic and 94% were afebrile. After correcting for reinfections, the cure rate by day 42 was 89% (95% confidence interval [95% CI] 87-91%). Three independent factors were found to predict recrudescence: age < 14 years (adjusted hazards ratio [AHR] = 1.6, 95% CI 1.1-2.3), initial parasitaemia greater than > 40,000/microL (AHR = 1.6, 95%, CI 1.2-2.2), and pure P. falciparum infections (AHR = 1.8, 95% CI 1.3-2.7). These 3 factors combined accounted for 62% of all treatment failures. Patients who received mefloquine on admission with a high admission parasitaemia (> 40,000/microL) had a three-fold (95% CI 1.3-7) risk of subsequent recrudescence compared with those who received their mefloquine on the second or third day (P = 0.01). There has been no decline in the efficacy of the 3 d artesunate plus mefloquine regimen since it was introduced in 1992. This regimen is safe, well tolerated, and highly effective in the treatment of multi-drug resistant falciparum malaria. |
| spellingShingle | Price, R Nosten, F Luxemburger, C van Vugt, M Phaipun, L Chongsuphajaisiddhi, T White, N Artesunate/mefloquine treatment of multi-drug resistant falciparum malaria. |
| title | Artesunate/mefloquine treatment of multi-drug resistant falciparum malaria. |
| title_full | Artesunate/mefloquine treatment of multi-drug resistant falciparum malaria. |
| title_fullStr | Artesunate/mefloquine treatment of multi-drug resistant falciparum malaria. |
| title_full_unstemmed | Artesunate/mefloquine treatment of multi-drug resistant falciparum malaria. |
| title_short | Artesunate/mefloquine treatment of multi-drug resistant falciparum malaria. |
| title_sort | artesunate mefloquine treatment of multi drug resistant falciparum malaria |
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