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An open, randomized trial of three-day treatment with artesunate combined with a standard dose of mefloquine divided over either two or three days, for acute, uncomplicated falciparum malaria.
Southeast Asian J Trop Med Public Health. 2005 May; 36(3):591-6.SA

Abstract

The combination of artesunate and mefloquine is currently one of the most effective treatments for multidrug-resistant Plasmodium falciparum malaria. Simultaneous, rather than sequential treatment with the two drugs, would allow better patient compliance. We therefore evaluated three-day treatment with artesunate combined with either 2 or 3 days of mefloquine co-administered once a day with artesunate. The study was an open, randomized trial for acute, uncomplicated falciparum malaria and was conducted at the Bangkok Hospital for Tropical Diseases. One hundred and twenty adult patients were randomized to two treatment groups. Group 1 patients received 4 mg/kg/day of artesunate for 3 days and 3 daily doses of 8.0 mg/kg/day mefloquine given with artesunate. Group 2 patients received the same dose of artesunate and the same total dose of mefloquine (25 mg/kg). However, the mefloquine was given as 15 mg/kg on the first day and 10 mg/kg/ on the second day, again with artesunate. The baseline demographic and clinical characteristics of the patients in the two groups were similar. The cure rates for the 3-day and 2-day mefloquine regimens were 100% and 99%, respectively. There were no significant differences in either median fever clearance times (group 1=32 hours; group 2=33 hours) or mean parasite clearance times (group 1=42.3 hours; group 2=43.3 hours). Both regimens were well tolerated and there were no significant differences in the incidence of adverse effects. Nausea or vomiting occurred in 3.8% of patients in both groups and transient dizziness occurred in 4% of group 1 and 9% of group 2 patients. These results suggest that a 3-day regimen of mefloquine administered with artesunate is effective and well tolerated. This practical regimen could improve patient compliance.

Authors+Show Affiliations

Silachamroon U
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok 10400, Thailand. tmusl@mahidol.ac.th
Krudsood S
No affiliation info available
Thanachartwet W
No affiliation info available
Tangpukdee N
No affiliation info available
Leowattana W
No affiliation info available
Chalermrut K
No affiliation info available
Srivilairit S
No affiliation info available
Wilaiaratana P
No affiliation info available
Thimasarn K
No affiliation info available
Looareesuwan S
No affiliation info available

MeSH

AdolescentAdultAnimalsAntimalarialsArtemisininsArtesunateDrug Therapy, CombinationFemaleHumansMalaria, FalciparumMaleMefloquineMiddle AgedPlasmodium falciparumSesquiterpenesTime FactorsTreatment Outcome

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16124422

Clinical Trial Links

Antimalaria Drugs Susceptibility Testing for an Effective Management of Infected Patients in Sub-Sahara Africa

Citation

Silachamroon, U, et al. "An Open, Randomized Trial of Three-day Treatment With Artesunate Combined With a Standard Dose of Mefloquine Divided Over Either Two or Three Days, for Acute, Uncomplicated Falciparum Malaria." The Southeast Asian Journal of Tropical Medicine and Public Health, vol. 36, no. 3, 2005, pp. 591-6.
Silachamroon U, Krudsood S, Thanachartwet W, et al. An open, randomized trial of three-day treatment with artesunate combined with a standard dose of mefloquine divided over either two or three days, for acute, uncomplicated falciparum malaria. Southeast Asian J Trop Med Public Health. 2005;36(3):591-6.
Silachamroon, U., Krudsood, S., Thanachartwet, W., Tangpukdee, N., Leowattana, W., Chalermrut, K., Srivilairit, S., Wilaiaratana, P., Thimasarn, K., & Looareesuwan, S. (2005). An open, randomized trial of three-day treatment with artesunate combined with a standard dose of mefloquine divided over either two or three days, for acute, uncomplicated falciparum malaria. The Southeast Asian Journal of Tropical Medicine and Public Health, 36(3), 591-6.
Silachamroon U, et al. An Open, Randomized Trial of Three-day Treatment With Artesunate Combined With a Standard Dose of Mefloquine Divided Over Either Two or Three Days, for Acute, Uncomplicated Falciparum Malaria. Southeast Asian J Trop Med Public Health. 2005;36(3):591-6. PubMed PMID: 16124422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An open, randomized trial of three-day treatment with artesunate combined with a standard dose of mefloquine divided over either two or three days, for acute, uncomplicated falciparum malaria. AU - Silachamroon,U, AU - Krudsood,S, AU - Thanachartwet,W, AU - Tangpukdee,N, AU - Leowattana,W, AU - Chalermrut,K, AU - Srivilairit,S, AU - Wilaiaratana,P, AU - Thimasarn,K, AU - Looareesuwan,S, PY - 2005/8/30/pubmed PY - 2006/11/4/medline PY - 2005/8/30/entrez SP - 591 EP - 6 JF - The Southeast Asian journal of tropical medicine and public health JO - Southeast Asian J Trop Med Public Health VL - 36 IS - 3 N2 - The combination of artesunate and mefloquine is currently one of the most effective treatments for multidrug-resistant Plasmodium falciparum malaria. Simultaneous, rather than sequential treatment with the two drugs, would allow better patient compliance. We therefore evaluated three-day treatment with artesunate combined with either 2 or 3 days of mefloquine co-administered once a day with artesunate. The study was an open, randomized trial for acute, uncomplicated falciparum malaria and was conducted at the Bangkok Hospital for Tropical Diseases. One hundred and twenty adult patients were randomized to two treatment groups. Group 1 patients received 4 mg/kg/day of artesunate for 3 days and 3 daily doses of 8.0 mg/kg/day mefloquine given with artesunate. Group 2 patients received the same dose of artesunate and the same total dose of mefloquine (25 mg/kg). However, the mefloquine was given as 15 mg/kg on the first day and 10 mg/kg/ on the second day, again with artesunate. The baseline demographic and clinical characteristics of the patients in the two groups were similar. The cure rates for the 3-day and 2-day mefloquine regimens were 100% and 99%, respectively. There were no significant differences in either median fever clearance times (group 1=32 hours; group 2=33 hours) or mean parasite clearance times (group 1=42.3 hours; group 2=43.3 hours). Both regimens were well tolerated and there were no significant differences in the incidence of adverse effects. Nausea or vomiting occurred in 3.8% of patients in both groups and transient dizziness occurred in 4% of group 1 and 9% of group 2 patients. These results suggest that a 3-day regimen of mefloquine administered with artesunate is effective and well tolerated. This practical regimen could improve patient compliance. SN - 0125-1562 UR - https://www.unboundmedicine.com/medline/citation/16124422/An_open_randomized_trial_of_three_day_treatment_with_artesunate_combined_with_a_standard_dose_of_mefloquine_divided_over_either_two_or_three_days_for_acute_uncomplicated_falciparum_malaria_ DB - PRIME DP - Unbound Medicine ER -
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