RANDOMIZED COMPARISON OF ARTEMETHER-BENFLUMETOL AND ARTESUNATE-MEFLOQUINE IN TREATMENT OF MULTIDRUG-RESISTANT FALCIPARUM-MALARIA

An open, randomized comparison of artemether-benflumetol (CGP 56 697; Novartis) with artesunate-mefloquine was conducted in 617 patients wit h acute uncomplicated multidrug-resistant falciparum malaria on the we stern border of Thailand. Both treatments rapidly and reliably cleared fever and parasitemia, and there was no significant difference in the initial therapeutic response parameters. Parasite genotyping was used to distinguish recrudescences from new infections. The 63-day cure ra te for artesunate-mefloquine (94%) was significantly higher than the c ure rate for artemether-benflumetol (81%) (P < 0.001). Both regimens w ere well tolerated. Nausea, vomiting, dizziness, sleep disorders, and other neurological side effects were between two and four times more c ommon in the artesunate-mefloquine group than in the artemether-benflu metol group (P < 0.001). Artemether-benflumetol is effective and very well tolerated in the treatment of multidrug-resistant falciparum mala ria. A higher dose than that used in the present study may improve eff icacy.