[A randomized comparative study of naphtoquine, mefloquine and artsunate in the treatment of falciparum malaria].
OBJECTIVE
To evaluate the efficacy and safety of naphtoquine, compared with mefloquine and artesunate in the treatment of falciparum malaria.


METHODS
Ninety patients with falciparum malaria were randomly allocated to 3 groups, including naphtoquine, mefloquine and artesunate group. In the naphtoquine group, thirty patients were prescribed single daily dosage of 1,000 mg for one day. In the mefloquine group, equal patients were treated with single dosage of 750 mg. Another thirty patients in the artesunate group were given total dosage of 600 mg for five days and doubling dosage on the first day.


RESULTS
In all three groups, symptoms were well controlled. The average fever-subsidence time in naphtoquine group was 30 h +/- 16 h and approximate that in mefloquine group (24 h +/- 15 h, P>0.05), but was longer than that in naphtoquine group (18 h +/- 9 h, P<0.01). The average parasite-clearance time in naphtoquine group (98 h +/- 28 h) is longer than that in mefloquine group (57 h +/- 20 h, P<0.01) and that in artesunate group (43 h +/- 17 h, P<0.01). At the end of 28-day clinical trail, the curative ratio in naphtoquine group was the highest (96.7%), and was significantly higher than that in mefloquine group (76.7%, P<0.05) and artesunate group (73.3%, P<0.05). Slight nausea and vomiting were observed in few patient in three groups.


CONCLUSIONS
Although the average fever-subsidence time and the parasite-clearance time of naphtoquine at single 24-hour dosage of 1,000 mg were longer than those of mefloquine and artesunate, the 28-day curative ratio of naphtoquine was higher than that of mefloquine and artesunate. So we recommend that the combination of artemisinin, which is a rapid action antimalarial, and naphtoquine or mefloquine, which are longterm action antimalarial, would contribute to promoting efficacy, shorting the period of treatment and delaying occurrence of drug resistance.
Guo
Wei-zhong
WZ
Tropical Medicine Institute, Guangzhong University of Traditional Chinese Medicine, Guangzhong 510405, China.
Guo
Xing-bo
XB
Zheng
Qi-jin
QJ
Tan
Bo
B
Chen
Ren-jun
RJ
Ou
Feng-zhen
FZ
Fu
Lin-chun
LC
D000293:Adolescent; D000328:Adult; D000634:Aminoquinolines / Q000627:therapeutic use; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D000077332:Artesunate; D002648:Child; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use*; D012717:Sesquiterpenes / Q000627:therapeutic use*
D000634:Aminoquinolines; D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D000077332:Artesunate; D015767:Mefloquine