Mefloquine-resistant falciparum malaria on the Thai-Burmese border
François NostenFeiko O. ter KuileT ChongsuphajaisiddhiNicholas J. WhiteFeiko O. ter KuileC. LuxemburgerH. Kyle WebsterMichael D. EdsteinL PhaipunKyaw Lay ThewNicholas J. White
242
Citation
15
Reference
10
Related Paper
Citation Trend
Keywords:
Sulfadoxine
Quinine
Sulfadoxine
Sulfadoxine/pyrimethamine
Cite
Citations (10)
A single oral dose (1.5 g) of mefloquine hydrochloride cured all of 37 patients with falciparum malaria, and a single dose of pyrimethamine (75 mg) plus sulfadoxine (1.5 g) cured 34 of 38 patients. The rates at which parasitaemia and fever abated were similar for the two regimens but mefloquine was associated with a higher incidence of gastrointestinal side effects.
Sulfadoxine
Sulfadoxine/pyrimethamine
Artesunate
Cite
Citations (73)
Sulfadoxine
Sulfadoxine/pyrimethamine
Cite
Citations (73)
This double-blind study is based on the treatment of 75 adult male patients suffering from Plasmodium falciparum malaria in Medellín, Colombia, a city in which there is no malaria transmission. The patients, who came from regions with high resistance to antimalarials, were divided into three groups receiving single-dose treatment as follows: a combination of 280 mg mefloquine, 800 mg sulfadoxine and 40 mg pyrimethamine; a combination of 420 mg mefloquine, 1200 mg sulfadoxine and 60 mg pyrimethamine; and a combination of 1500 mg sulfadoxine and 75 mg pyrimethamine. After treatment, follow-up examination was performed daily for I week and then weekly for another 3 weeks. The cure rate in the mefloquine groups (within the study period of 28 days) was 100%, and in the third group 75%. Normal blood levels of the administered drugs were found in 6 patients of the third group who were not cured; they were subsequently cured with a single dose of 1000 mg of mefloquine. Drug tolerance was good and no toxic effects were demonstrated in blood and urine examinations. While the doses in the drug combinations (containing mefloquine) gave very good results, we would recommend a slightly higher dose combination of mefloquine with sulfadoxine-pyrimethamine for the treatment of falciparum malaria in areas with a high prevalence of chloroquine resistance.
Sulfadoxine
Sulfadoxine/pyrimethamine
Quinine
Cite
Citations (17)
Journal Article Double-blind dose finding study of mefloquine-sulfadoxine-pyrimethamine in children with acute falciparum malaria Get access X.B. Guo, X.B. Guo 1Malaria Research Unit, Guangzhou College of Traditional Chinese Medicine, Guangzhou, Guangdong, People's Republic of China Search for other works by this author on: Oxford Academic PubMed Google Scholar K. Arnold, K. Arnold ∗ 2Roche Asian Research Foundation, P.O. Box 98595, Tsimshatsui, Hong Kong ∗Author for correspondence. Search for other works by this author on: Oxford Academic PubMed Google Scholar L.C. Fu, L.C. Fu 1Malaria Research Unit, Guangzhou College of Traditional Chinese Medicine, Guangzhou, Guangdong, People's Republic of China Search for other works by this author on: Oxford Academic PubMed Google Scholar P.Q. Chen, P.Q. Chen 1Malaria Research Unit, Guangzhou College of Traditional Chinese Medicine, Guangzhou, Guangdong, People's Republic of China Search for other works by this author on: Oxford Academic PubMed Google Scholar G.Q. Li G.Q. Li 1Malaria Research Unit, Guangzhou College of Traditional Chinese Medicine, Guangzhou, Guangdong, People's Republic of China Search for other works by this author on: Oxford Academic PubMed Google Scholar Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 82, Issue 4, July-August 1988, Pages 538–540, https://doi.org/10.1016/0035-9203(88)90496-8 Published: 01 July 1988 Article history Received: 03 March 1988 Accepted: 18 March 1988 Published: 01 July 1988
Sulfadoxine
Sulfadoxine/pyrimethamine
Cite
Citations (7)
In the face of an increasing prevalence of Plasmodium falciparum resistant to chloroquine and to pyrimethamine-sulphonamide or -sulphone mixtures, the need for a new, effective blood schizontocide for treatment of acute malaria is urgent. The only such compound that is almost ready for release is mefloquine (M) but there is already a danger that parasites may become resistant to this compound if it is used extensively alone. Earlier studies using a rodent model indicated that mefloquine could be ‘protected’ by administering it with a pyrimethamine sulfadoxine (PS) mixture, but the experimental technique used was open to criticism. The present experiments, using a relapse technique to develop drug resistance, more closely parallel the way antimalarials are likely to be deployed in human communities. They confirm that the development of resistance to the individual components in the P. berghei N line is delayed by the triple combination, and more so in the slightly chloroquine-resistant 'P. berghei NS' line. The combination did not prevent the development of resistance in a line initially resistant to PS, but the level reached was much less than those seen when P. berghei N or 'P. berghei NS' were exposed to MPS or to M alone. It was concluded that the use of a triple combination of M, P and S against P. falciparum would be of value in ‘protecting’ these compounds, and thus gain time while new agents against malaria are being developed.
Plasmodium berghei
Sulfadoxine
Quinine
Cite
Citations (41)
Journal Article Fansidar resistant falciparum malaria acquired in South East Asia Get access F. Black, F. Black 1Rigshospitalet, Dept. of Communicable and Tropical Diseases, Copenhagen, Denmark Search for other works by this author on: Oxford Academic PubMed Google Scholar I. Bygbjerg, I. Bygbjerg 1Rigshospitalet, Dept. of Communicable and Tropical Diseases, Copenhagen, Denmark Search for other works by this author on: Oxford Academic PubMed Google Scholar P. Effersøe, P. Effersøe ⋆ 1Rigshospitalet, Dept. of Communicable and Tropical Diseases, Copenhagen, Denmark ⋆Correspondence to: P. Effersee, M 7722/2460, Rigshospitalet, Tagensvej 18, DK-2200 Copenhagen N, Denmark. Search for other works by this author on: Oxford Academic PubMed Google Scholar Grethe Gomme, Grethe Gomme 2Statens Seruminstitut, Dept. of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark Search for other works by this author on: Oxford Academic PubMed Google Scholar S. Jepsen, S. Jepsen 3Statens Seruminstitut, Dept. of Treponematoses, Copenhagen, Denmark Search for other works by this author on: Oxford Academic PubMed Google Scholar G.Axelgaard Jensen G.Axelgaard Jensen 4County Hospital, Depts of Medicine and Paediatrics, Kolding, Denmark Search for other works by this author on: Oxford Academic PubMed Google Scholar Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 75, Issue 5, 1981, Pages 715–716, https://doi.org/10.1016/0035-9203(81)90160-7 Published: 01 January 1981 Article history Published: 01 January 1981 Accepted: 16 February 1981
Cite
Citations (27)
Patients with falciparum malaria were studied in Thailand, an area of known chloroquine resistance. The patients were unselected and some had severe malaria, and they were randomly assigned to one of two sequential regimes. A short course of quinine (average 4 doses, equivalent to 2 g base) followed by a single dose of pyrimethamine-sulfadoxine (Fansidar) cured 92% of patients (36 out of 39), while a short course of quinine followed by a single 1-5-dose of mefloquine cured all of the 35 patients who could be followed up. Gastrointestinal side effects were minimal if at least 12 hours elapsed between the last dose of quinine and the mefloquine. Sequential quinine and mefloquine is the most effective treatment for patients with chloroquine-resistant falciparum malaria, including those with severe or complicated disease. Mefloquine, however, is not commercially available, and the similar regimen using Fansidar is almost as effective.
Quinine
Sulfadoxine
Regimen
Sulfadoxine/pyrimethamine
Cite
Citations (55)
The plasma concentrations of sulfadoxine, pyrimethamine, mefloquine and its major metabolite were determined in 18 healthy male volunteers who had regularly taken either 500 mg of sulfadoxine and 25 mg of pyrimethamine (Fansidar) weekly or 250 mg mefloquine regularly every 14 d during 6 months for malaria prophylaxis. The mean trough concentrations of sulfadoxine, pyrimethamine and mefloquine were 194, 0.28 and 1.48 mumol/litre and the mean half lives were 7.7, 4.2 and 25 d respectively. The variation in area under the curve for the 3 drugs was only 2-3 fold. The findings do not indicate that drug accumulation or induction of metabolism occurred during long-term usage.
Sulfadoxine
Sulfadoxine/pyrimethamine
Malaria prophylaxis
Cite
Citations (26)
An in vivo study of the response of P. falciparum to the combination drug, MSP, was conducted among gem miners who contracted malaria from Cambodia in 1991-1992. High level resistance (RII, RIII responses) was observed in 22.5% of the 40 cases attending Mae Sot malaria clinic, west Thailand border, and in 28.1% of the 96 cases attending Bo Rai malaria clinic, east Thailand border. The observations on in vitro studies conducted prior to the MSP treatment and after recrudescence, together with the findings on adequate mefloquine blood levels strongly indicated the serious deterioration of mefloquine efficacy. The first line treatment for the malaria control program needs to be revised and the use of qinghaosu derivatives considered. Intensive measures to combat spreading of the highly resistant strains to other parts of the country should be taken into account.
Sulfadoxine/pyrimethamine
Sulfadoxine
Cite
Citations (28)