HIGH-DOSE MEFLOQUINE IN THE TREATMENT OF MULTIDRUG-RESISTANT FALCIPARUM-MALARIA

被引:86
作者
TERKUILE, FO
NOSTEN, F
THIEREN, M
LUXEMBURGER, C
EDSTEIN, MD
CHONGSUPHAJAISIDDHI, T
PHAIPUN, L
WEBSTER, HK
WHITE, NJ
机构
[1] ARMED FORCES RES INST MED SCI,USA MED COMPONENT,BANGKOK,THAILAND
[2] SHOKLO MALARIA RES UNIT,MAE SOD,THAILAND
[3] UNIV AMSTERDAM,ACAD MED CTR,INFECT DIS & TROP MED UNIT,AMSTERDAM,NETHERLANDS
[4] WHO,DISASTER SUB REG OFF,SAN JOSE,COSTA RICA
[5] JOHN RADCLIFFE HOSP,NUFFIELD DEPT CLIN MED,OXFORD OX3 9DU,ENGLAND
基金
英国惠康基金;
关键词
D O I
10.1093/infdis/166.6.1393
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The therapeutic efficacy and toxicity of a high-dose (25 mg/kg) mefloquine regimen (M25) and the currently recommended regimen of 15 mg/kg (M15) were compared in 199 patients with acute falciparum malaria in an area with deteriorating multidrug resistance on the Thai-Burmese border. The clinical and parasitologic responses were significantly more rapid with M25. The incidence of treatment failures by day 7-9 was 7% for M15 and 7% for M 25 (P = .03) and had increased to 40% and 9%, respectively, by day 28 (P < .000 1). Overall failure rates were highest in children (P = .02). Parasite clearance times were a good predictor of the therapeutic response; all patients with parasitemia persisting >5 days after treatment experienced subsequent recrudescence. Side effects were dose-related and included dizziness, anorexia, nausea, vomiting, and fatigue. Although vomiting <1 h after treatment was more likely in young children, children overall tolerated mefloquine better than adults, and men better than women. The optimum treatment dose of mefloquine in this area is 25 mg/kg.
引用
收藏
页码:1393 / 1400
页数:8
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