[Study on treatment of multi-drug resistant falciparum malaria by using a combination of dihydroartemisinin and pyronaridine].
OBJECTIVE
To provide a combined medication scheme for the treatment of multi-drug resistant falciparum malaria.


METHODS
Combined administration of dihydroartemisinin and pyronaridine was given to the 32 cases of falciparum malaria cases with multi-drug resistance. The indices for evaluation on day 14, 21, and 28 after treatment included the mean fever subsidence time, mean asexual form clearance time, mean recrudescence time of asexual form and recrudescence rate, proportion of gametocyte carriers, mean density of gametocytes and its mean clearance time, cure rate and rate of side-effects. A double blind clinical test was performed with standard schemes of dihydroartemisinin (20 cases) and pyronaridine (25 cases) as control.


RESULTS
The mean fever subsidence time of treated patients by dihydroartemisinin/pyronaridine combination, dihydroartemisinin and pyronaridine was 35.7 +/- 24.7 h, 52.6 +/- 38.9 h and 35.8 +/- 16.5 h respectively, showing a significant difference between the combination group and dihydroartemisinin groups (P < 0.01). The mean asexual form clearance time was 23.8 +/- 10.1 h, 22.9 +/- 6.5 h and 49.4 +/- 20.3 h respectively, showing significantly faster in the combination group than the pyronaridine group (P < 0.01). The recrudescence rate was 0, 4.2% and 0 respectively. The proportion of gametocyte carriers was 20.0%, 16.7% and 60.9% respectively, with a significantly higher rate in the group of pyronaridine than the group of combination (P < 0.01).


CONCLUSIONS
The combination of dihydroartemsinin and pyronaridine is an ideal medication scheme for the treatment of falciparum malaria cases with multi-drug resistance.
Liu
De-quan
DQ
Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025.
Lin
Shi-gan
SG
Feng
Xiao-ping
XP
Chen
Wen-jiang
WJ
Chen
Pu-lin
PL
Wu
Hui-min
HM
Chen
Chang
C
Liu
Jian
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000008:administration & dosage*; D037621:Artemisinins / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D018432:Drug Resistance, Multiple; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008875:Middle Aged; D009287:Naphthyridines / Q000008:administration & dosage*; D012717:Sesquiterpenes / Q000008:administration & dosage*
D000962:Antimalarials; D037621:Artemisinins; D009287:Naphthyridines; D012717:Sesquiterpenes; C039060:artenimol; C027871:pyronaridine