Paediatrica Indonesiana (Oct 2016)
Comparative efficacy of chloroquine and pyrimethamine-sulfadoxine versus artemether and pyrimethamine-sulfadoxine in the treatment of uncomplicated falciparum malaria in children
Abstract
Background Large amount of data show that chloroquine and pyrimethamine-sulfadoxine (PS) as standard drugs for falciparum malaria cause resistance; for that reason new drugs or combina- tion drugs are urgently needed. Artemether is one of the new drugs. It has been studied extensively in China and Southeast Asia during the past 10 years. The effectiveness of this drug in clearing parasites has been thoroughly documented. Objective The objective of this study was to investigate the efficacy of the combination of chloroquine and PS compared to artemether and PS in the treatment of uncomplicated falciparum malaria. Methods We did a single-blind randomized study on 60 children with uncomplicated falciparum malaria. Thirty children were treated with chloroquine (10 mg/kg for 2 days, then 5 mg/kg in the 3 rd day) and PS (pyrimethamine 1-1.5 mg/kg single dose on the 1 st day) and the other 30 children were treated with artemether (4 mg/kg/day for 3 days) and PS. All patients were admitted to hospital for at least 7 days. Results Fever clearance time was significantly shorter in the group that received artemether and PS compared to that in the chloro- quine-and-PS group (42 hours vs. 75 hours 50 minutes, p<0.0001). Parasite clearance time was significantly different between the group that received artemether and PS and the chloroquine-and- PS group (2.5 days vs. 3.1 days, p=0.04). The cure rate in the chloroquine-and-PS group was 28/30 and that of the artemether- and-PS group was 30/30. Nausea and vomiting were found in 1 patient treated with chloroquine and PS. Conclusion The combined treatment of artemether and PS was well tolerated. No adverse reactions attributable to the treatment were noted
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