ARTESUNATE VERSUS ARTEMETHER IN COMBINATION WITH MEFLOQUINE FOR THE TREATMENT OF MULTIDRUG-RESISTANT FALCIPARUM-MALARIA
ARTESUNATE VERSUS ARTEMETHER IN COMBINATION WITH MEFLOQUINE FOR THE TREATMENT OF MULTIDRUG-RESISTANT FALCIPARUM-MALARIA
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DOI：
10.1016/0035-9203(95)90094-2
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发表时间：
1995-09-01
影响因子：
2.2
通讯作者：
WHITE, NJ
中科院分区：
文献类型：
--
作者：
PRICE, RN;NOSTEN, F;WHITE, NJ
为了比较口服青蒿琥酯和蒿甲醚联合甲氟喹治疗耐多药疟疾的疗效，在泰缅边境的540名成人和儿童中进行了一项试验。比较了三种方案：青蒿琥酯（4 mg/kg/d，持续3d）、蒿甲醚（4 mg/kg/d，持续3d），两者均与甲氟喹（25 mg/kg）组合，以及单剂量甲氟喹（25 mg/kg）。青蒿琥酯和蒿甲醚方案的临床和寄生虫学反应非常相似，耐受性都很好。青蒿素衍生物无明显不良反应。甲氟喹单药治疗的发热和寄生虫清除时间明显延长（P < 0.001）。调整再感染后，青蒿琥酯联合用药的失败率为13.9%，蒿甲醚联合用药的失败率为12.3%，甲氟喹单药的失败率为49.2%（P < 0.0001;相对危险度为3.8 [95%置信区间为2.6-5.4]）。甲氟喹不应再单独用于该地区耐多药恶性疟疾的治疗。青蒿琥酯或蒿甲醚的三天联合方案耐受性良好，更有效。
To compare the therapeutic efficacy of oral artesunate and artemether in combination with mefloquine for the treatment of mutidrug resistant malaria, a trial was conducted in 540 adults and children on the Thai-Myanmar border. Three regimens were compared: artesunate (4 mg/kg/d for 3 d), artemether (4 mg/kg/d for 3 d), both in combination with mefloquine (25 mg/kg), and a single dose of mefloquine (25 mg/kg). The artesunate and artemether regimens gave very similar clinical and parasitological responses, and were both very well tolerated. There was no significant adverse effect attributable to the artemisinin derivatives. Fever and parasite clearance times with mefloquine alone were significantly longer (P < 0.001). After adjusting for reinfections the failure rates were 13.9% for the artesunate combination, 12.3% for the artemether combination and 49.2% for mefloquine alone (P < 0.0001; relative risk 3.8 [95% confidence interval 2.6-5.4]). Mefloquine should no longer be used alone for the treatment of multidrug resistant falciparum malaria in this area. Three-day combination regimens with artesunate or artemether are well tolerated and more effective.