RANDOMIZED TRIAL OF ARTESUNATE AND MEFLOQUINE ALONE AND IN SEQUENCE FOR ACUTE UNCOMPLICATED FALCIPARUM-MALARIA
RANDOMIZED TRIAL OF ARTESUNATE AND MEFLOQUINE ALONE AND IN SEQUENCE FOR ACUTE UNCOMPLICATED FALCIPARUM-MALARIA
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DOI：
10.1016/0140-6736(92)90276-9
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发表时间：
1992-04-04
期刊：
影响因子：
168.9
通讯作者：
WEBSTER, K
中科院分区：
文献类型：
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作者：
LOOAREESUWAN, S;VIRAVAN, C;WEBSTER, K
泰国恶性疟疾治疗失败的频率不断增加，表明迫切需要有效的药物或药物组合。青蒿素衍生物青蒿琥酯可快速清除寄生虫血症，但复发率可高达50%。我们比较了青蒿琥酯联合甲氟喹与单独使用每种药物治疗急性、无并发症的恶性疟疾的效果。127 名患者被随机分配接受青蒿琥酯（5 天 600 毫克）、甲氟喹（750 毫克，6 小时后 500 毫克）或青蒿琥酯联合甲氟喹治疗。所有患者均住院28天以排除再感染。治愈被定义为在28天的随访期间没有复发。单独使用甲氟喹和青蒿酯的治愈率分别为 81%（30/37 例患者）和 88%（35/40）；该组合对 39 名患者均有效。接受青蒿琥酯治疗的组的发烧和寄生虫清除时间明显短于仅使用甲氟喹的组。接受这两种药物治疗的患者恶心和呕吐的频率略高于其他组，但并不显着。青蒿琥酯联合甲氟喹治疗泰国急性、无并发症的恶性疟疾患者非常有效，且耐受性良好。
The increasing frequency of therapeutic failures in falciparum malaria in Thailand shows an urgent need for effective drugs or drug combinations. Artesunate, a qinghaosu derivative, is effective in clearing parasitaemia rapidly, but the recrudescence rate can be as high as 50%. We have compared artesunate followed by mefloquine with each drug alone in acute, uncomplicated falciparum malaria.127 patients were randomly assigned treatment with artesunate (600 mg over 5 days), mefloquine (750 mg then 500 mg 6 h later), or artesunate followed by mefloquine. All patients were admitted to hospital for 28 days to exclude reinfection. Cure was defined as no recrudescence during the 28 days' follow-up. The cure rates for mefloquine and artesunate alone were 81% (30/37 patients) and 88% (35/40); the combination was effective in all of 39 patients. Fever and parasite clearance times were significantly shorter in the groups that received artesunate than in the mefloquine-only group. The frequency of nausea and vomiting was slightly, but not significantly, higher among patients who received both drugs than in the other groups.The combination of artesunate followed by mefloquine is highly effective and well tolerated in patients with acute, uncomplicated falciparum malaria in Thailand.