Vivax malaria: preliminary observations following a shorter course of treatment with artesunate plus primaquine.
The standard adult treatment regimen for Plasmodium vivax malaria is chloroquine (1500 mg over 3 d) plus primaquine (15 or 30 mg daily for 14 d), but patient compliance tends to be poor with the lengthy course. Preliminary observations are reported on the efficacy of a shorter treatment course - artesunate (200mg twice a day for 2 d) plus primaquine (22.5mg base twice a day for 7 d) - given to 28 adult patients infected with P. vivax in Viet Nam. All patients responded quickly to treatment with mean (SD) parasite and fever clearance times of 14.2 (4.0) and 18.6 (8.4) h, respectively. The high dose of primaquine was generally well tolerated, and only one patient (3.6%) had a recurrence of parasitaemia during 28 d of follow-up. As most patients infected with Southeast Asian strains of P. vivax have their first relapse within 28 d after treatment with rapidly eliminated blood schizonticides, the absence of parasitaemia in the remaining 27 patients suggests that this drug regimen was active against both blood and liver stages. Further studies are needed to confirm that this rapidly acting, short artesunate-primaquine regimen can result in better patient compliance and treatment outcomes than the chloroquine-primaquine regimen.
Dao
Nguyen Van Hoang
NV
Department of Infectious Diseases, Military Hospital 175, Ho Chi Minh City, Viet Nam.
Cuong
Bui Tri
BT
Ngoa
Nguyen Dang
ND
Thuy
Le Thi Thanh
le TT
The
Nguyen Duy
ND
Duy
Dinh Ngoc
DN
Dai
Bui
B
Thanh
Nguyen Xuan
NX
Chavchich
Marina
M
Rieckmann
Karl H
KH
Edstein
Michael D
MD
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D037621:Artemisinins / Q000008:administration & dosage / Q000627:therapeutic use*; D000077332:Artesunate; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016780:Malaria, Vivax / Q000097:blood / Q000188:drug therapy*; D008297:Male; D011319:Primaquine / Q000008:administration & dosage / Q000627:therapeutic use*; D055502:Secondary Prevention; D012717:Sesquiterpenes / Q000008:administration & dosage / Q000627:therapeutic use*
D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D000077332:Artesunate; D011319:Primaquine