Comparative clinical trial of artesunate followed by mefloquine in the treatment of acute uncomplicated falciparum malaria: two- and three-day regimens.
Comparative clinical trial of artesunate followed by mefloquine in the treatment of acute uncomplicated falciparum malaria: two- and three-day regimens.
复制标题
青蒿琥酯随后甲氟喹治疗急性单纯性恶性疟疾的比较临床试验：两天和三天的治疗方案。
DOI：
10.4269/ajtmh.1996.54.210
复制
发表时间：
1996
期刊：
影响因子：
--
通讯作者：
M. Andrial
中科院分区：
文献类型：
--
作者：
S. Looareesuwan;C. Viravan;S. Vanijanonta;P. Wilairatana;P. Pitisuttithum;M. Andrial
在泰国，治疗耐药性恶性疟疾的困难由于需要长期服用抗疟药而变得更加困难。由此导致的患者依从性下降不仅降低了治愈率，而且还导致耐药性进一步蔓延。我们比较了 111 名急性无并发症恶性疟疾患者在两天和三天内给予的两种序贯治疗方案的疗效。第 1 组中，67 名患者接受了两剂 400 mg 剂量的青蒿琥酯（总剂量 = 800 mg），随后接受了两剂甲氟喹（立即给予 750 mg，12 小时后给予 500 mg；总剂量 = 1,250 mg）。 44 名患者（第二组）接受了四剂 200 mg 剂量的青蒿酯（总剂量 = 800 mg）。间隔 12 小时，然后服用甲氟喹 治疗方案与第一组相似。所有患者均在曼谷住院 28 天，以防止再次感染。九十六名患者完成了这项研究。两组的治愈率，第一组为 84%（58 例中的 49 例），第二组为 100%（38 例中的 38 例）。 II组的平均寄生虫清除时间和发烧清除时间显着缩短（P < 0.02）。未出现严重不良反应。第一组中所有 9 例治疗失败均为 RI 类型。结果表明，先用青蒿琥酯后用甲氟喹连续治疗三天，对急性、无并发症的恶性疟疾患者有效且耐受性良好，适合作为耐多药恶性疟疾的替代治疗。
The difficulties in treating drug-resistant falciparum malaria in Thailand are compounded by the necessity of giving antimalarials over long periods of time. The resultant decrease in patient compliance not only lowers cure rates but also predisposes to the further spread of drug resistance. We compared the efficacy of two sequential treatment regimens given over two and three days in 111 patients with acute uncomplicated falciparum malaria. Sixty-seven patients received two 400-mg doses of artesunate (total dose = 800 mg) followed by two doses of mefloquine (750 mg given immediately and 500 mg 12 hr later; total dose = 1,250 mg) in Group 1. Forty-four patients (Group II) received four 200-mg doses of artesunate (total dose = 800 mg) given 12 hr apart followed by a mefloquine regimen similar to that for Group I. All patients were admitted to hospital in Bangkok for 28 days to preclude reinfection. Ninety-six patients completed the study. Cure rates for the two groups were 84% (49 of 58) for Group I and 100% (38 of 38) for Group II. The mean parasite clearance time and fever clearance time were significantly shorter in Group II (P < 0.02). There were no serious adverse reactions. All nine of the treatment failures in Group I were of the RI types. The results indicate that the sequential treatment with artesunate followed by mefloquine given over three days is effective and well-tolerated in patients with acute, uncomplicated falciparum malaria and suitable as an alternative treatment for multidrug-resistant falciparum malaria.