Clinical trial of sequential treatments of moderately severe and severe malaria with dihydroartemisinin suppository followed by mefloquine in Thailand

One hundred and fifty patients with severe falciparum malaria were administ ered sequential combination of dihydroartemisinin suppository followed by a n oral mefloquine tablet. Dihydroartemisinin suppositories (80 mg/ capsule) were given rectally once daily for 3 days with a total dose of 8-10 mg/kg. Two doses of mefloquine, 15 mg/kg/dose and 10 mg/kg/dose, were given at 72 hr and 84 hr, respectively. The mean [SD] parasite clearance time and feve r clearance time were 46.1 [15.7] hr and 82.5 [59.6] hr, respectively. No d eath or major adverse drug effects occurred. The cure rate at 28 days of in patient follow-up was 95% (113 of 119 patients). In severe malaria, dihydro artemisinin suppository followed by oral mefloquine is a suitable alternati ve treatment to parenteral drugs.