TREATMENT OF ACUTE, UNCOMPLICATED, FALCIPARUM-MALARIA WITH ORAL DIHYDROARTEMISININ

A clinical trial of oral dihydroartemisinin for the treatment of acute , uncomplicated, falciparum malaria involved 53 adult patients in Thai land. Each received a total dose of 480 mg ol er 7 days (120 mg given immediately, followed by 60 mg/day) after being admitted to the Hospit al for Tropical Diseases in Bangkok for 28 days. Most(92%) completed t he 28-day follow-up but four patients left the hospital early, for rea sons unrelated to their treatment. Most patients showed clinical impro vement 1-3 days after starting treatment and none suffered from seriou s adverse reactions. The cure rate was 90% (44/49). The mean (S.D.) pa rasite-clearance lime was 404 (14.1) h and the mean fever-clearance ti me was 37.0 (30.2) h. Seven patients had a brief increase in parasitae mia after initiation of treatment but subsequent counts declined drama tically. Five patients who failed treatment (RI response) were success fully treated with quinine plus tetracycline for 7 days. No RII or RII I responses were observed. These findings Indicate that treatment with oral dihydroartemisinin is effective and well tolerated, and that dih ydroartemisinin may be suitable as an alternative treatment for acute, uncomplicated, Falciparum malaria. Comparisons with other conventiona l antimalarial drugs in a large, double-blind, randomized trial and st udies of dihydroartemisinin in combination with other, long-acting ant imalarials are needed.