[Tolerance and efficacy of mefloquine as the first line treatment of uncomplicated P. falciparum malaria in children].
BACKGROUND
Given the national therapeutic guidelines in France, halofantrine represents the first line treatment of uncomplicated Plasmodium falciparum (P. falciparum) malaria in children. But several disadvantages exist using halofantrine in paediatrics.


OBJECTIVE
The primary objective of this study is to evaluate the tolerance and the efficacy of mefloquine as the first line treatment of uncomplicated P. falciparum malaria in a paediatric emergency department. The secondary objective of the study is to evaluate whether symptomatic measures may improve the gastrointestinal tolerance of mefloquine.


METHODS
This retrospective observational cohort study includes all the patients who have been treated for acute uncomplicated P. falciparum malaria in the paediatric emergency department of the Hospital Trousseau (Paris, France) in 2003.


RESULTS
First line treatment was mefloquine in 35 children. Early vomiting occurred in 22 (63%) cases. All children responded to mefloquine therapy except two children who had persistent vomiting early after mefloquine therapy and required intravenous quinine. Those two children had initial vomiting. Light meal and metopimazine prophylaxis did not precede mefloquine intake in those two children.


CONCLUSIONS
This study suggests that mefloquine treatment of uncomplicated P. falciparum malaria is effective and well tolerated in children. Furthermore, a light meal and metopimazine prophylaxis preceding mefloquine intake may improve its gastrointestinal tolerance.
Valeyre
P
P
Urgences pédiatriques, hôpital d'enfants Armand-Trousseau, AP-HP, 26, rue du Dr-Netter, 75571 Paris cedex 12, France.
Favier
R
R
Adam
M
M
Quinet
B
B
Grimprel
E
E
Parez
N
N
D000293:Adolescent; D000932:Antiemetics / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005502:Food; D006801:Humans; D007223:Infant; D007540:Isonipecotic Acids / Q000008:administration & dosage; D016778:Malaria, Falciparum / Q000188:drug therapy*; D015767:Mefloquine / Q000009:adverse effects* / Q000627:therapeutic use*; D012189:Retrospective Studies; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control
D000932:Antiemetics; D007540:Isonipecotic Acids; C005260:metopimazine; D015767:Mefloquine