TREATMENT OF PATIENTS WITH RECRUDESCENT FALCIPARUM-MALARIA WITH A SEQUENTIAL COMBINATION OF ARTESUNATE AND MEFLOQUINE
TREATMENT OF PATIENTS WITH RECRUDESCENT FALCIPARUM-MALARIA WITH A SEQUENTIAL COMBINATION OF ARTESUNATE AND MEFLOQUINE
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DOI：
10.4269/ajtmh.1992.47.794
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发表时间：
1992-12-01
影响因子：
3.3
通讯作者：
WEBSTER, HK
中科院分区：
文献类型：
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作者：
LOOAREESUWAN, S;KYLE, DE;WEBSTER, HK
对24例急性复发恶性疟患者进行了青蒿琥酯序贯联合甲氟喹的前瞻性评价。序贯组合用于最大限度地减少可能的副作用，并利用青蒿琥酯快速清除寄生虫血症的能力和甲氟喹清除残留寄生虫的长期作用。所有患者均经历过一次或多次以下药物（单独或联合给药）治疗失败：奎宁、四环素、甲氟喹、青蒿琥酯和磺胺嘧啶/乙胺嘧啶。青蒿琥酯（600毫克，5天），然后甲氟喹（750毫克和500毫克，间隔6小时）顺序治疗治愈所有24例患者。每例患者随访28天，10例观察至少35天，无复发的临床或寄生虫学证据。序贯联合给药后的发热和寄生虫清除时间分别为32.8 +/- 19.3 h（平均值+/- SD）和40.0 +/- 16.2 h。选定的寄生虫分离株的敏感性测试表明，所有测试的分离株耐一种或多种抗疟药物。这些结果表明，序贯治疗青蒿琥酯，然后甲氟喹是有效的，耐受性良好的复发恶性疟疾患者。
A sequential combination of artesunate followed by mefloquine was evaluated prospectively in 24 patients with acute recrudescent falciparum malaria. The sequential combination was used to minimize possible side effects and to take advantage of the ability of artesunate to rapidly clear parasitemia and the prolonged effect of mefloquine to clear residual parasites. All patients had experienced one or more treatment failures with one or more courses of the following drugs (administered alone or in combination): quinine, tetracycline, mefloquine, artesunate, and sulfadoxine/pyrimethamine. Sequential treatment with artesunate (600 mg over five days) followed by mefloquine (750 mg and 500 mg six hours apart) cured all 24 patients. Each patient was followed for 28 days and 10 were observed for at least 35 days without clinical or parasitologic evidence of recrudescence. Fever and parasite clearance times after treatment with the sequential combination were 32.8 +/- 19.3 hr (mean +/- SD) and 40.0 +/- 16.2 hr, respectively. Susceptibility testing of selected parasite isolates indicated that all of the isolates tested were resistant to one or more antimalarial drugs. These results suggest that sequential treatment with artesunate followed by mefloquine is effective and well-tolerated in patients with recrudescent falciparum malaria.