Efficacy of primaquine regimens for primaquine-resistant Plasmodium vivax malaria in Thailand
| Autor: | S. Looareesuwan, Weerapong Phumratanaprapin, Polrat Wilairatana, Valai Bussaratid, Srivicha Krudsood, Pratap Singhasivanon, S Srivilirit, Sombat Treeprasertsuk, Udomsak Silachamroon |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Primaquine Adolescent Sulfadoxine medicine.medical_treatment Plasmodium vivax Drug Resistance Artesunate Parasitemia Pharmacology Antimalarials chemistry.chemical_compound Virology Internal medicine parasitic diseases Malaria Vivax medicine Animals Humans Aged Chemotherapy biology business.industry Middle Aged medicine.disease biology.organism_classification Artemisinins Drug Combinations Pyrimethamine Treatment Outcome Infectious Diseases chemistry Female Parasitology business Sesquiterpenes Malaria medicine.drug |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1476-1645 0002-9637 |
| DOI: | 10.4269/ajtmh.1999.61.973 |
| Popis: | To define the current efficacy of Fansidar (F. Hoffmann-La Roche Ltd., Basel Switzerland) (pyrimethamine and sulfadoxine), primaquine in a high dose, and artesunate for treating acute Plasmodium vivax malaria, we conducted a comparative clinical trial of these 3 drugs in an open-label study. Patients (15-65 years old) were assigned to 1 of 4 treatments regimens in a serial order. Ninety percent of the patients were infected at Thailand-Myanmar border. Patients in group I (n = 23) received Fansidar (3 tablets, 75 mg of pyrimethamine and 1,500 mg of sulfadoxine, a single dose on the first day), group II (n = 23) received Fansidar (3 tablets, 75 mg of pyrimethamine and 1,500 mg of sulfadoxine, a single dose on the first day) and then received primaquine (30 mg a day for 14 days), group III (n = 23) received primaquine (30 mg a day for 14 days), and group IV (n = 23) received artesunate (200 mg once a day for 3 days) and then primaquine (30 mg a day for 14 days). Cure rates on day 28 of follow-up were 40%, 100%, 100%, and 100% in groups I, II, II, and IV, respectively. There were 4 and 5 patients in group I showing post-treatment reappearance of parasitemia at < or = 16 days and between 17 and 28 days, respectively. Patients in the other 3 groups showed negative parasitemias within 7 days after treatment. Artesunate plus primaquine (group IV) cleared parasitemia faster than the other 3 regimens. There is a high proportion of ineffectiveness of Fansidar for treatment of P. vivax malaria and it should be no longer used for treatment of P. vivax malaria acquired at the Thailand-Myanmar border. A high dose of primaquine is safe and effective in the treatment of P. vivax malaria during the 28-day follow-up period. |
| Databáze: | OpenAIRE |
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