A COMPARATIVE CLINICAL-TRIAL OF ARTEMETHER AND THE SEQUENTIAL REGIMENOF ARTEMETHER-MEFLOQUINE IN MULTIDRUG-RESISTANT FALCIPARUM-MALARIA

A randomized, comparative clinical trial for assessment of the efficac y of two antimalarial regimens, artemether alone and the sequential re gimen artemether-mefloquine, was carried out in 109 Thai male patients with acute uncomplicated, multidrug resistant falciparum malaria who were admitted to the Bangkok Hospital for Tropical Diseases. Fifty-thr ee patients received oral artemether at a total dose of 700 mg(300 mg initially, followed by 100 mg daily for 4 days), and 56 patients recei ved the sequential regimen of artemether-mefloquine (300 mg oral artem ether initially, followed by 750 mg oral mefloquine after 24 h). Patie nts in both groups had a rapid initial response to treatment, with a m edian parasite clearance time of 40 h compared with 43.5 h for the seq uential regimen. Median fever clearance times were 42.5 h and 32.5 h f or artemether and the sequential regimen respectively. Parasitaemia re occurred in patients of both groups during the follow up period, six i n the artemether and three in the sequential regimen (cure rates were 88 and 94%). No serious adverse effects were observed in either group of patients.