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Treatment Of Multidrug-Resistant Plasmodium Falciparum Malaria With 3-Day Artesunate-Mefloquine Combination
Abstract
Studies of 652 adults and children with acute uncomplicated falciparum malaria were done to determine the optimum treatment of multidrug-resistant Plasmodium falciparum malaria on the Thai-Burmese border. Single-dose artesunate (4 mg/kg) plus mefloquine (25 mg of base/kg) gave more rapid symptomatic and parasitologic responses than high-dose mefloquine alone but did not improve cure rates. Three days of artesunate (total dose, 10 mg/kg) plus mefloquine was 98% effective compared with a 28-day failure rate of 31% with high-dose mefloquine alone (relative risk [RR], 0.06; 95% confidence interval [CI], 0.02-0.2; P < .0001). By day 63, the reinfection adjusted failure rates were 2% and 44%, respectively (P < .0001). Artesunate also prevented high-grade failures. Both drugs were well tolerated. No adverse effects were attributable to artesunate. Vomiting was reduced significantly by giving mefloquine on day 2 of treatment (RR, 0.40; 95% CI, 0.20-0.79; P = .009. Artesunate (10 mg/kg over 3 days) plus mefloquine (25 mg/kg) is currently the most effective treatment for falciparum malaria in this area of increasing mefloquine resistance.
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Citations
Cited by
Artemisinin Resistance in Plasmodium falciparum Malaria
Dondorp, A. M., Nosten, F., Yi, P., Das, D., Phyo, A. P., Tarning, J., Lwin, K. M., Ariey, F., Hanpithakpong, W., Lee, S. J., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0808859 · Cited by 3,424
Self-citationQinghaosu (Artemisinin): The Price of Success
White, N. J. (2008) · Science · doi:10.1126/science.1155165 · Cited by 954
Self-citationA Medicinal Chemistry Perspective on Artemisinin and Related Endoperoxides
O'Neill, P. M., & Posner, G. H. (2004) · Journal of Medicinal Chemistry · doi:10.1021/jm030571c · Cited by 538
Nosten, F., van Vugt, M., Price, R., Luxemburger, C., Thway, K., Brockman, A., McGready, R., ter Kuile, F., Looareesuwan, S., & White, N. (2000) · The Lancet · doi:10.1016/s0140-6736(00)02505-8 · Cited by 500
Self-citationArtemisinin and the antimalarial endoperoxides: from herbal remedy to targeted chemotherapy
Meshnick, S. R., Taylor, T. E., & Kamchonwongpaisan, S. (1996) · Microbiological Reviews · doi:10.1128/mmbr.60.2.301-315.1996 · Cited by 710
“Thailand (122) ART (10 mg/kg, 3 days) 1 PO MQ (25 mg/kg, 1 day) 179 ART group faster”
Background
Metadata
- Authors
- Nosten, F., Luxemburger, C., ter Kuile, F. O., Woodrow, C., Pa Eh, J., Chongsuphajaisiddhi, T., & White, N. J.
- Venue
- Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1994-10-01
- Volume
- 170
- Issue
- 4
- Pages
- 971-977
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2120475095
- Cited by
- 229
- References
- 0
- FWCI
- 12.82
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Treatment Of Multidrug-Resistant Plasmodium Falciparum Malaria With 3-Day Artesunate-Mefloquine Combination. https://app.cochat.ai/papers/10.1093/infdis/170.4.971
- The paper
- Nosten, F., Luxemburger, C., ter Kuile, F. O., Woodrow, C., Pa Eh, J., Chongsuphajaisiddhi, T., & White, N. J. (1994). Treatment Of Multidrug-Resistant Plasmodium Falciparum Malaria With 3-Day Artesunate-Mefloquine Combination. Journal of Infectious Diseases. https://doi.org/10.1093/infdis/170.4.971
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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