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Prevention of increasing rates of treatment failure by combining sulfadoxine-pyrimethamine with artesunate or amodiaquine for the sequential treatment of malaria.
J Infect Dis. 2003 Oct 15; 188(8):1231-8.JI

Abstract

Combination antimalarial therapy may delay the spread of drug resistance, but clinical data supporting this notion are limited. For 1 year, we studied Ugandan children who were treated for uncomplicated malaria with sulfadoxine-pyrimethamine (SP), SP + amodiaquine (AQ), or SP + artesunate (AS). We compared treatment responses and the prevalence of resistance-conferring mutations of new infections with those of recrudescent infections due to parasites that survived prior treatment. Recrudescent infections were associated with the selection of SP resistance-conferring mutations in all treatment groups, but responses to repeat therapy differed. Compared with initial treatments, treatment of recrudescent infections was associated with a higher rate of treatment failure (hazard ratio [HR], 2.44; P=.01), for the SP group, but with a lower rate of treatment failure (HR, 0.40; P=.08), for the SP + AS group. Treatment failure in the SP + AQ group was uncommon, limiting the analysis of recrudescent parasites. Our results suggest that the use of combination antimalarial therapy in Africa may slow the spread of drug-resistant malaria and prolong the therapeutic life span of available treatment regimens.

Authors+Show Affiliations

Department of Medicine, San Francisco General Hospital, University of California, San Francisco 94143, USA. grantd@itsa.ucsf.edu.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14551894

Citation

Dorsey, Grant, et al. "Prevention of Increasing Rates of Treatment Failure By Combining Sulfadoxine-pyrimethamine With Artesunate or Amodiaquine for the Sequential Treatment of Malaria." The Journal of Infectious Diseases, vol. 188, no. 8, 2003, pp. 1231-8.
Dorsey G, Vlahos J, Kamya MR, et al. Prevention of increasing rates of treatment failure by combining sulfadoxine-pyrimethamine with artesunate or amodiaquine for the sequential treatment of malaria. J Infect Dis. 2003;188(8):1231-8.
Dorsey, G., Vlahos, J., Kamya, M. R., Staedke, S. G., & Rosenthal, P. J. (2003). Prevention of increasing rates of treatment failure by combining sulfadoxine-pyrimethamine with artesunate or amodiaquine for the sequential treatment of malaria. The Journal of Infectious Diseases, 188(8), 1231-8.
Dorsey G, et al. Prevention of Increasing Rates of Treatment Failure By Combining Sulfadoxine-pyrimethamine With Artesunate or Amodiaquine for the Sequential Treatment of Malaria. J Infect Dis. 2003 Oct 15;188(8):1231-8. PubMed PMID: 14551894.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of increasing rates of treatment failure by combining sulfadoxine-pyrimethamine with artesunate or amodiaquine for the sequential treatment of malaria. AU - Dorsey,Grant, AU - Vlahos,Jonathan, AU - Kamya,Moses R, AU - Staedke,Sarah G, AU - Rosenthal,Philip J, Y1 - 2003/10/10/ PY - 2003/03/28/received PY - 2003/05/03/accepted PY - 2003/10/11/pubmed PY - 2003/12/3/medline PY - 2003/10/11/entrez SP - 1231 EP - 8 JF - The Journal of infectious diseases JO - J Infect Dis VL - 188 IS - 8 N2 - Combination antimalarial therapy may delay the spread of drug resistance, but clinical data supporting this notion are limited. For 1 year, we studied Ugandan children who were treated for uncomplicated malaria with sulfadoxine-pyrimethamine (SP), SP + amodiaquine (AQ), or SP + artesunate (AS). We compared treatment responses and the prevalence of resistance-conferring mutations of new infections with those of recrudescent infections due to parasites that survived prior treatment. Recrudescent infections were associated with the selection of SP resistance-conferring mutations in all treatment groups, but responses to repeat therapy differed. Compared with initial treatments, treatment of recrudescent infections was associated with a higher rate of treatment failure (hazard ratio [HR], 2.44; P=.01), for the SP group, but with a lower rate of treatment failure (HR, 0.40; P=.08), for the SP + AS group. Treatment failure in the SP + AQ group was uncommon, limiting the analysis of recrudescent parasites. Our results suggest that the use of combination antimalarial therapy in Africa may slow the spread of drug-resistant malaria and prolong the therapeutic life span of available treatment regimens. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/14551894/Prevention_of_increasing_rates_of_treatment_failure_by_combining_sulfadoxine_pyrimethamine_with_artesunate_or_amodiaquine_for_the_sequential_treatment_of_malaria_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/378523 DB - PRIME DP - Unbound Medicine ER -