Croft A M, Garner P
Headquarters Defence Secondary Care Agency, Ministry of Defence, Room 570, St Giles' Court, 1-13 St Giles' High Street, London, UK, WC2H 8LD.
Cochrane Database Syst Rev. 2000(2):CD000138. doi: 10.1002/14651858.CD000138.
Mefloquine has now largely replaced earlier malaria prophylaxis drugs which are no longer considered to be effective against all Plasmodium species, due to parasite resistance. However mefloquine may be associated with neuropsychological harmful effects. The objective of this review was to assess the effects of mefloquine in adult travellers.
We searched the Cochrane Infectious Diseases Group trials register, Medline, Embase, Lilacs, Science Citation Index and reference lists of articles. We contacted researchers in the subject of malaria chemoprophylaxis, and drug companies.
Randomised trials comparing mefloquine with other standard prophylaxis or placebo in non-immune adult travellers.
The two reviewers independently assessed trial quality and extracted data. Study authors were also contacted.
Ten trials involving 2750 non-immune adult travellers were included. One trial comparing mefloquine with placebo showed mefloquine prevented malaria episodes in an area of drug resistance (odds ratio 0.04, 95% confidence interval 0.02 to 0.08). Withdrawals in the mefloquine group were consistently higher in four placebo controlled trials (odds ratio 3. 56, 95% confidence interval 1.67 to 7.60). In five trials comparing mefloquine with other chemoprophylaxis, no difference in tolerability was detected.
REVIEWER'S CONCLUSIONS: Mefloquine prevents malaria, but there is not enough evidence to evaluate its tolerability and toxicity, particularly for general travellers.
由于疟原虫耐药性，甲氟喹现已在很大程度上取代了早期的疟疾预防药物，这些早期药物不再被认为对所有疟原虫种类都有效。然而，甲氟喹可能会带来神经心理方面的有害影响。本综述的目的是评估甲氟喹对成年旅行者的影响。
我们检索了Cochrane传染病组试验注册库、医学期刊数据库（Medline）、荷兰医学文摘数据库（Embase）、拉丁美洲和加勒比地区卫生科学数据库（Lilacs）、科学引文索引以及文章的参考文献列表。我们联系了疟疾化学预防领域的研究人员和制药公司。
在非免疫成年旅行者中比较甲氟喹与其他标准预防措施或安慰剂的随机试验。
两位综述作者独立评估试验质量并提取数据。我们还联系了研究报告的作者。
纳入了10项涉及2750名非免疫成年旅行者的试验。一项比较甲氟喹与安慰剂的试验表明，在耐药地区甲氟喹可预防疟疾发作（比值比0.04，95%置信区间0.02至0.08）。在四项安慰剂对照试验中，甲氟喹组的退出率始终较高（比值比3.56，95%置信区间1.67至7.60）。在五项比较甲氟喹与其他化学预防措施的试验中，未检测到耐受性方面的差异。
甲氟喹可预防疟疾，但没有足够的证据来评估其耐受性和毒性，尤其是对于一般旅行者而言。
