COMPARISON OF MICRONIZED HALOFANTRINE WITH CHLOROQUINE-ANTIBIOTIC COMBINATIONS FOR TREATING PLASMODIUM-FALCIPARUM MALARIA IN ADULTS FROM GABON

Multidrug resistance of Plasmodium falciparum is spreading throughout Africa. In Lambarene, Gabon where chloroquine-resistant malaria is pre valent, a randomized comparative trial with three regimens for treatin g P. falciparum malaria in adults was performed. One hundred two patie nts evaluated received either a new micronized formulation of halofant rine (8 mg/kg every 6 hr in three doses) (group H) or chloroquine (25 mg/kg for a 48-hr period) plus clindamycin (5 mg/kg every 12 hr in six doses) (group CC1), or chloroquine (as above) plus doxycycline (2 mg/ kg every 12 hr in six doses) (group CD). All treatment regimens were w ell-tolerated. In group H, 100% of the patients were cured, and in gro up CC1, 97% of the patients were cured by day 28 of follow-up. In grou p CD, a significantly lower cure rate of 75% (P < 0.01) and a slower p arasite clearance was observed, but only low grade (RI) resistance occ urred.