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Prospective randomized trials with oral artemisinin derivatives have been conducted in over 1000 patients to determine the optimum treatment of multi-drug resistant falciparum malaria on the Thai-Burmese border. These drugs have proved valuable in 3 settings. (i) Primary treatment of uncomplicated malaria in combination with mefloquine, when they accelerate the rate of recovery, eliminate the risk of dangerous early failures, and if given for 3 d or more improve overall cure rates; (ii) treatment of recrudescent infections, which otherwise have a high failure rate; and (iii) oral treatment of patients with high parasitaemias (> or = 4%) but no clinical evidence of severity (a group who would usually receive parenteral quinine). The parenteral formulation of artemether is absorbed if given rectally, and this may offer a practical alternative method of treating severe malaria in rural areas.

Original publication

DOI

10.1016/0035-9203(94)90472-3

Type

Journal article

Journal

Transactions of the Royal Society of Tropical Medicine and Hygiene

Publication Date

06/1994

Volume

88 Suppl 1

Pages

S45 - S46

Addresses

Shoklo Malaria Research Unit, Mae Sod, Thailand.

Keywords

Humans, Malaria, Falciparum, Sesquiterpenes, Artemisinins, Mefloquine, Suppositories, Drug Combinations, Antiprotozoal Agents, Antimalarials, Administration, Oral, Prospective Studies, Drug Resistance