title: Successful treatment of Plasmodium falciparum malaria with a six-dose regimen of artemether-lumefantrine versus quinine-doxycycline in the Western Amazon region of Brazil.
abstract: This randomized, open-label study compared a three-day, six-dose regimen of artemether-lumefantrine with a five-day, 19-dose regimen of quinine-doxycycline for the treatment of Plasmodium falciparum malaria in the western Amazon region of Brazil. All patients remained hospitalized during their treatment and the study assessments were scheduled daily from the start of treatment (day 0) through day 6. By day 3, the percentage of infected patients was 0% in the artemether-lumefantrine group and 48.8% in the quinine-doxycycline group. Median parasite clearance time was significantly shorter in the artemether-lumefantrine group (two days) compared with the quinine-doxycycline group (three days) (P < 0.0001). Two patients in the quinine-doxycycline group left the study early because of treatment ineffectiveness or adverse event. Adverse events were reported by 91.5% of the study participants, most of which were mild in severity and/or not considered related to study treatment. Artemether-lumefantrine was shown to be an efficacious, safe, and convenient treatment for P. falciparum malaria in a highly drug-resistant region of South America.
authors.affiliation: Tropical Medicine Foundation of Amazonas, Manaus, Amazonas, Brazil.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Alecrim
authors.forename: Marcus V
authors.initials: MV
authors.lastname: Lacerda
authors.forename: Maria P
authors.initials: MP
authors.lastname: Mourão
authors.forename: Wilson D
authors.initials: WD
authors.lastname: Alecrim
authors.forename: Alexandre
authors.initials: A
authors.lastname: Padilha
authors.forename: Bernardo S
authors.initials: BS
authors.lastname: Cardoso
authors.forename: Marcos
authors.initials: M
authors.lastname: Boulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use; D000077549:Artemether; D037621:Artemisinins / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D004318:Doxycycline / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D005449:Fluorenes / Q000627:therapeutic use*; D006801:Humans; D000078102:Lumefantrine; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum; D011803:Quinine / Q000627:therapeutic use*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004983:Ethanolamines; D005449:Fluorenes; D011803:Quinine; D000077549:Artemether; D000078102:Lumefantrine; D004318:Doxycycline