Randomised trial of pyronaridine versus chloroquine for acute uncomplicated falciparum malaria in Africa
Randomised trial of pyronaridine versus chloroquine for acute uncomplicated falciparum malaria in Africa
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DOI：
10.1016/s0140-6736(96)91558-5
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发表时间：
1996-01-06
期刊：
影响因子：
168.9
通讯作者：
Basco, L
中科院分区：
文献类型：
--
作者：
Ringwald, P;Bickii, J;Basco, L
氯喹耐药性的蔓延在非洲构成了一个严重的问题，在非洲恶性疟疾传播是世界上最高的。吡咯吡啶是一种吖啶衍生物，在中国已成功用于治疗疟疾20多年。我们比较了吡咯啶和氯喹在喀麦隆雅温得非洲成年急性无并发症恶性疟疾患者中的疗效，在那里氯喹耐药性已经确立。方法96例患者随机给予氯喹25 mg/kg或吡咯啶32 mg/kg口服治疗，疗程3 d。在门诊基础上对患者进行了至少14天的随访。通过非主动治疗进行分析。结果随访失败（11例）或自行服用奎宁（4例）后，41例使用氯喹治疗，40例使用吡啶治疗。在使用氯喹和吡咯啶的14天随访期间，寄生虫清除率分别为44%和100%。所有用吡咯啶治疗的患者在第3天发热，第4天寄生虫病清除。在吡咯啶治疗的患者中未发现严重的药物相关副作用。解释吡咯啶在非洲急性、无并发症恶性疟疾患者中迅速有效且耐受性良好，可能是抗氯喹耐药疟疾的替代药物。
Background The spread of chloroquine resistance poses a serious problem in Africa, where falciparum malaria transmission is the highest in the world. Pyronaridine, an acridine derivative, has been used successfully to treat malaria in China for over 20 years. We compared the efficacy of pyronaridine and chloroquine in African adult patients with acute uncomplicated falciparum malaria in Yaounde, Cameroon, where chloroquine resistance is well established.Methods 96 patients were randomly assigned treatment with chioroquine 25 mg/kg or pyronaridine 32 mg/kg, both orally and divided over 3 days. Patients were followed up for at least 14 days on an outpatient basis. Analysis was by on-active-treatment.Findings After losses from follow-up (11) or because of self-medication with quinine (four), 41 patients treated with chloroquine and 40 treated with pyronaridine were analysed. Parasite clearance during the 14-day follow-up with chioroquine and pyronaridine was 44% and 100%, respectively. All patients treated with pyronaridine were afebrile by day 3, and parasitaemia cleared by day 4. No serious drug-related side-effects were noted in pyronaridine-treated patients.Interpretation Pyronaridine was rapidly effective and well-tolerated in African patients with acute, uncomplicated falciparum malaria and may represent an alternative drug against chloroquine-resistant malaria.