TY - JOUR T1 - Randomized comparison of chloroquine plus sulfadoxine-pyrimethamine versus artesunate plus mefloquine versus artemether-lumefantrine in the treatment of uncomplicated falciparum malaria in the Lao People's Democratic Republic. AU - Mayxay,Mayfong, AU - Khanthavong,Maniphone, AU - Lindegårdh,Niklas, AU - Keola,Siamphay, AU - Barends,Marion, AU - Pongvongsa,Tiengkham, AU - Yapom,Ratsuda, AU - Annerberg,Anna, AU - Phompida,Samlane, AU - Phetsouvanh,Rattanaxay, AU - White,Nicholas J, AU - Newton,Paul N, Y1 - 2004/09/27/ PY - 2004/02/10/received PY - 2004/05/25/accepted PY - 2004/10/16/pubmed PY - 2006/6/2/medline PY - 2004/10/16/entrez SP - 1139 EP - 47 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 39 IS - 8 N2 - BACKGROUND: Recent clinical trials in the Lao People's Democratic Republic have demonstrated that chloroquine and sulfadoxine-pyrimethamine, which are national malaria treatment policy, are no longer effective in the treatment of uncomplicated Plasmodium falciparum malaria. METHODS: A randomized comparison of 3 oral antimalarial combinations--chloroquine plus sulfadoxine-pyrimethamine versus artesunate plus mefloquine versus artemether-lumefantrine--with 42-day follow-up period, was conducted among 330 patients with acute uncomplicated falciparum malaria in southern Laos. RESULTS: The 42-day cure rates, as determined by intention-to-treat analysis and adjusted for reinfection, were 100%, 97%, and 93% for the groups receiving artesunate plus mefloquine, artemether-lumefantrine, and chloroquine plus sulfadoxine-pyrimethamine, respectively. Of 8 patients receiving chloroquine plus sulfadoxine-pyrimethamine who experienced treatment failure, 6 had early treatment failure. The mean parasite clearance time was significantly longer in patients treated with chloroquine plus sulfadoxine-pyrimethamine (2.9 days; 95% confidence interval [CI], 2.8-3.0 days) than in those treated with artesunate plus mefloquine (2.07 days; 95% CI, 2.0-2.1 days; P<.001) and artemether-lumefantrine (2.08 days; 95% CI, 2.0-2.1 days; P<.001). Cure rates with artemether-lumefantrine were high despite low mean daily dietary fat intake (13.8 g; 95% CI, 12.5-15.1 g) and day 7 plasma lumefantrine concentrations (0.47 mu g/mL; 95% CI, 0.38-0.56 mu g/mL). CONCLUSION: Oral artesunate plus mefloquine and artemether-lumefantrine are highly effective for the treatment of uncomplicated falciparum malaria in Laos. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/15486837/Randomized_comparison_of_chloroquine_plus_sulfadoxine_pyrimethamine_versus_artesunate_plus_mefloquine_versus_artemether_lumefantrine_in_the_treatment_of_uncomplicated_falciparum_malaria_in_the_Lao_People's_Democratic_Republic_ DB - PRIME DP - Unbound Medicine ER -