A Clinical Trial of Mefloquine in the Treatment of Plasmodium vivax Malaria *

Dixon, Kenneth E.; Pitaktong, Utit; Phintuyothin, P

doi:10.4269/ajtmh.1985.34.435

Cited by 14 publications

(9 citation statements)

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“…Both infections subsequently resolved after re-treatment with chloroquine. A study from Thailand [4] compared the efficacy of a single 1500-mg dose of mefloquine in 15 adults with P. vivax malaria with a 1500-mg dose of chloroquine, with or without primaquine, given over the course of 3 days to 25 adults with P. vivax malaria; it revealed 28-day cure rates of 100% in all groups. A more recent study from Thailand, where chloroquine remains effective against P. vivax, reported recurrent parasitemia in 2 of 17 mefloquine-treated patients (15 mg base/kg) and 1 of 21 chloroquine-treated patients (25 mg base/ kg) cases only after day 28 [6].…”

Section: Discussionmentioning

confidence: 99%

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Mefloquine Is Highly Efficacious against Chloroquine-Resistant Plasmodium vivax Malaria and Plasmodium falciparum Malaria in Papua, Indonesia

Maguire¹,

Krisin²,

Marwoto

et al. 2006

Clinical Infectious Diseases

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Combination therapy is one method of overcoming the global challenge of drug-resistant Plasmodium falciparum malaria. We conducted a hospital-based 28-day in vivo test comparing chloroquine/doxycycline to chlo-roquine or doxycycline alone for treating P. falciparum and Plasmodium vivax malaria in Irian Jaya, Indonesia. Eighty-nine patients with uncomplicated falciparum malaria were randomized to standard dose chloroquine (n 30), doxycycline (100 mg every 12 hours [7 days], n 20), or chloroquine with doxycycline (n 39); corresponding numbers for vivax malaria (n 63) were 23, 16, 24. Endpoints were parasite sensitivity (S) or resistance (RI/RII/ RIII). Of the 105 evaluable patients, chloroquine/doxycycline cured (S) 20/22 (90.9% [95% CI 78.9-100%]) patients with P. falciparum malaria; 2/22 (9.1% [0-21%]) were RIII resistant. Doxycycline cured 11/17 (64.7% [42.0-87.4%]) patients, and chloroquine 4/20 (20% [2.5-37.5%]). Against P. vivax, chloroquine/doxycycline cured (S) 12/17 (70.6% [48.9-92.2%]) patients, doxycycline 4/12 (33.3% [6.6-59.9%]), and chloroquine 5/17 (29.4% [7.7-51.1%]). Chloroquine/doxycycline was effective against P. falciparum but only modestly effective against P. vivax. These findings support the use of chloroquine/doxycycline as an inexpensive alternative to mefloquine for treating chloro-quine-resistant P. falciparum but not chloroquine-resistant P. vivax in this setting.

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Section: Discussionmentioning

confidence: 99%

“…However, published data supporting the use of mefloquine for P. vivax malaria is limited to treatment outcomes from 85 courses of therapy [2][3][4][5][6]. These data are also limited to settings where the comparator agent was chloroquine, for which clinical susceptibility has been confirmed.…”

mentioning

confidence: 99%

Mefloquine Is Highly Efficacious against Chloroquine-Resistant Plasmodium vivax Malaria and Plasmodium falciparum Malaria in Papua, Indonesia

Maguire¹,

Krisin²,

Marwoto

et al. 2006

Clinical Infectious Diseases

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“…Effective therapies for chloroquine-resistant P. vivax A few reports describe the efficacy of approved drugs for the treatment of P. vivax [50][51][52][53], and some reports describe treatments for CQ-resistant P. vivax [54][55][56]. Mefloquine (MQ) combined with PQ was effective in Papua, Indonesia (98% efficacy) [47], and CQ combined with PQ was much more effective than CQ alone [47,54].…”

Section: Failing Chloroquine Therapymentioning

confidence: 99%

Neglect of Plasmodium vivax malaria

Baird¹

2007

Trends in Parasitology

240

166

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“…The best option may be atovaquone-proguanil, with mefloquine or quinine plus tetracycline or doxycycline as alternatives. Both quinine (3 days) and either tetracycline or doxycycline (7 days) [121][122][123][124][125][126][127][128] and mefloquine [129][130][131][132][133][134][135] have been historically used successfully in case reports or small case series. More recently, both atovaquone-proguanil, in a relatively small study, 99 and mefloquine (at 15 mg/kg) 136 have effectively treated P vivax malaria in Indonesia, where high rates of CRPV exist.…”

Section: Uncomplicated Non-falciparum Malariamentioning

confidence: 99%