Expert review - Treating an uncomplicated form of Plasmodium falciparum malaria in adults

This article reviews current strategies used in the treatment of uncomplica ted forms of malaria due to Plasmodium falciparum. A comprehensive search i n selected medical databases (Medline, Pascal, and Embase) was performed on publications containing specific key words (P. falciparum, uncomplicated m alaria, halofantrine, mefloquine, quinine, amodiaquine, sulfadoxine, pyrime thamine, and atovaquone). Only relevant review articles, randomized control led therapeutic trials, and open trials written in English or French were s elected. Most publications dealt with drug therapy against chemoresistant s trains of P. falciparum in immune and semi-immune individuals, while some d iscussed antimalarial treatment in nonimmune subjects. Search results indic ated that first-line antimalarial agents included halofantrine, mefloquine, and quinine, alone or in combination with tetracycline antibiotics. Criter ia for choosing a particular drug included toxicity, contraindications, and geographical origin of the patient. The presence of any single severe clin ical or biological symptom made hospitalization mandatory. (C) 1999 Edition s scientifiques et medicales Elsevier SAS.