RANDOMIZED CONTROLLED TRIAL OF ARTESUNATE PLUS TETRACYCLINE VERSUS STANDARD TREATMENT (QUININE PLUS TETRACYCLINE) FOR UNCOMPLICATED PLASMODIUM-FALCIPARUM MALARIA IN BRAZIL

A triple-blind, randomized, clinical trial was undertaken in a Brazili an Amazon region to compare the effectiveness of oral artesunate (seve n days, total dose = 0.75 g) plus tetracycline (seven days, total dose = 10.5 g) (AT) and oral quinine (three days, total dose = 6 g) plus t etracycline (seven days, total dose = 10.5 g) (QT) against uncomplicat ed Plasmodium falciparum malaria. Effectiveness was assessed by cure r ates (World Health Organization [WHO]) and parasite clearance at day 2 . Patients were randomized, 88 to each group. The groups had similar b aseline clinical characteristics. The incidence of side effects was mu ch higher in the QT group (82%) than in the AT group (50%) (P < 0.001) . Cure rates were similar: 80% in the AT group and 77% in the QT group (P = 0.68). Parasitemia (by day 2) cleared faster in the AT group tha n in the QT group (98.5% versus 47.6%, respectively; P < 0.001). These results indicate that the combination of artesunate plus tetracycline is effective in the treatment of uncomplicated falciparum malaria and may provide a useful alternative to other treatment regimens.