Chloroquine or amodiaquine combined with sulfadoxine-pyrimethamine for uncomplicated malaria: a systematic review
Chloroquine or amodiaquine combined with sulfadoxine-pyrimethamine for uncomplicated malaria: a systematic review
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DOI：
10.1111/j.1365-3156.2006.01571.x
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发表时间：
2006-06-01
影响因子：
3.3
通讯作者：
Dorsey, Grant
中科院分区：
文献类型：
--
作者：
Hwang, Jimee;Bitarakwate, Edward;Dorsey, Grant
目的比较氯喹（CQ）、阿莫地喹（AQ）、磺胺多辛-乙胺嘧啶（SP）及其联用治疗无并发症恶性疟疾的疗效。方法：我们检索Medline、Embase、Cochrane中央对照试验注册库、BIOSIS、Web of Science、African Index Medicus、DARE、Digital Dissertations和Current Controlled Trials，检索1991年至2004年6月间进行的随机或准随机对照试验，不论其语言和地理位置。我们还联系了疟疾专家，检索了参考文献列表，并联系了未报告的种马、特征和其他数据的个别作者。未发表的数据被纳入分析。结果：共纳入13项随机试验（n = 4248），计算28天治疗失败的总相对风险。与SP单药治疗相比，在SP中加入CQ有边际获益（RR = 0.74, 95% CI 0.54-1.02）。AQ联合SP治疗失败的风险明显低于SP单药治疗（RR = 0.35, 95% CI 0.15-0.82）和AQ单药治疗（RR = 0.59, 95% CI 0.42-0.83）。与CQ + SP相比，AQ + SP治疗失败的风险显著降低（RR = 0.42, 95% CI 0.25-0.72）。严重的不良事件是罕见的，并没有增加联合治疗。结论在某些情况下，阿莫地喹加SP仍然是一种有效、经济、安全的治疗疟疾的选择。
OBJECTIVE To compare the efficacies against uncomplicated falciparum malaria of chloroquine (CQ), amodiaquine (AQ), sulfadoxine-pyrimethamine (SP) and combinations of these inexpensive drugs.METHODS We searched Medline, Embase, Cochrane CENTRAL Register of Controlled Trials, BIOSIS, Web of Science, African Index Medicus, DARE, Digital Dissertations and Current Controlled Trials for randomised or quasi-randomised controlled trials conducted between 1991 and June 2004 regardless of language and geography. We also contacted malaria experts, searched reference lists, and contacted individual authors for unreported stud), characteristics and additional data. Unpublished data were sought and included in the analyses.RESULTS Thirteen randomised trials (n = 4248) were identified and the summary relative risks of treatment failure at 28 days were calculated. There was marginal benefit in adding CQ to SP, compared with SP monotherapy (RR = 0.74, 95% CI 0.54-1.02). Combining AQ with SP was associated with a significantly lower risk of treatment failure than SP monotherapy (RR = 0.35, 95% CI 0.15-0.82) and AQ monotherapy (RR = 0.59, 95% CI 0.42-0.83). AQ plus SP was associated with a significantly lower risk of treatment failure than CQ plus SP (RR = 0.42, 95% CI 0.25-0.72). Serious adverse events were rare and did not increase with combination therapy.CONCLUSION Amodiaquine plus SP remains an efficacious, affordable and safe option for treating malaria in certain settings.