Artemisinin for treatment of uncomplicated falciparum malaria: Is there a place for monotherapy?

被引:56
作者
Giao, PT
Binh, TQ
Kager, PA
Long, HP
Thang, NV
Nam, NV
De Vries, PJ
机构
[1] Acad Med Ctr, Div Infect Dis Trop Med & AIDS, NL-1100 DE Amsterdam, Netherlands
[2] Cho Ray Hosp, Tro Dis Clin Res Ctr, Ho Chi Minh City, Vietnam
[3] Binh Thuan Prov Malaria Stn, Phan Thiet, Binh Thuan Prov, Vietnam
关键词
D O I
10.4269/ajtmh.2001.65.690
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The efficacy of artemisinin monotherapy was studied in 227 patients with uncomplicated falciparum malaria. They all received artemisinin at t = 0 hr, t = 8 hr, and thereafter once daily; treatment was extended at random until they had taken either 5 days of artemisinin followed by 2 days of placebo (A5), or 7 days (A7) of artemisinin. The adult artemisinin dose was 500 mg; children aged <15 years received 10 mg/kg per dose. The median (range) parasite clearance time was 39 (8-112) hr for A5 and 43 (38-104) hr for A7 (P = 0.085). The recrudescence rates were similar between the groups. The lowest parasite count achieved during treatment (P-term) was associated with the occurrence of recrudescence (P = 0.046, Cox regression model); it was lower for patients with a radical cure or late recrudescence than for early recrudescence (P = 0.034, t-test). Artemisinin monotherapy may offer rapid recovery and fast parasite clearance, but recrudescence is frequent. Extending the duration of monotherapy from 5 days to 7 days does not reduce recrudescence.
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页码:690 / 695
页数:6
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