No benefits from combining chloroquine with artesunate for three days for treatment of Plasmodium falciparum in Guinea-Bissau

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• 作者：Poul-Erik Kofoed ; Anja Poulsen ; Fern ; o Có ; Kathryn Hedegaard ; Peter Aaby ; Lars Rombo
• 关键词：malaria ; Plasmodium falciparum ; artemisinin ; chloroquine ; children ; Guinea-Bissau
• 刊名：Transactions of the Royal Society of Tropical Medicine and Hygiene
• 出版年：2003
• 出版时间：July - August 2003
• 年：2003
• 卷：97
• 期：4
• 页码：429-433
• 全文大小：618 K

文摘

The use of a combination of chloroquine and artesunate has been suggested for treatment of malaria in Africa. We used concomitant as well as sequential medication with these 2 drugs in relation to each drug separately for children infected with Plasmodium falciparum in Guinea-Bissau from March 2000 to November 2001. By block-randomization, 474 children with symptomatic malaria were divided into 4 groups and given either a total of 8 mg artesunate per kg bodyweight for 3 d, a total of 25 mg chloroquine base per kg bodyweight for 3 d, both drugs concomitantly for 3 d, or both drugs in sequence. All children were followed weekly for 5 weeks. On day 28, parasites had been detected in 40 % of the children who were treated with artesunate only compared with 21 % treated with chloroquine, 20 % treated with artesunate in combination with chloroquine, and 16 % treated with artesunate and chloroquine in sequence; on day 35 the corresponding percentages were 48 % , 29 % , 27 % , and 24 % , respectively. The outcome of the combination of chloroquine and artesunate in the doses studied was similar to the outcome of chloroquine monotherapy regardless of whether the 2 drugs are given concomitantly (relative risk [RR] = 0.93, 95 % CI 0.56-1.53, P= 0.76) or in sequence (RR = 0.78, 95 % CI 0.47–1.28, P = 0.32). Thus, neither an antagonistic, an additive, or a synergistic effect of the 2 drugs was indicated.