Krudsood S, Silachamroon U, Wilairatana P, Singhasivanon P, Phumratanaprapin W, Chalermrut K, Phophak N, Popa C
Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 2000 Dec;31(4):801-7.
Recently, a combination of artesunate and mefloquine has proved effective, although is contraindicated in early pregnancy and young children. Azithromycin, a widely used antibiotic and has antimalarial effects, replace mefloquine as a new alternative antimalarial regimen. Two hundred and two uncomplicated falciparum malaria patients were randomly assigned to 1 of 3 regimens. Patients in group I (n = 68) received artesunate 200 mg once daily for 3 days, group II (n = 67) received artesunate 200 mg together with mefloquine 10 mg/kg on the first 2 days and artesunate 200 mg together with mefloquine 5 mg/kg on the third day, and group III (n = 67) received artesunate 200 mg together with azithromycin 50 mg once daily for 3 days. The 28 day cure rates were 44, 98 and 56%, respectively. The median time to recrudescence was significantly longer in group III. In conclusion, a combination of artesunate and azithromycin might be useful in treating children in whom bacterial and malarial infections may be concomitant. However, further work is required in order to enhance its clinical efficacy.
最近，青蒿琥酯和甲氟喹的联合用药已被证明有效，尽管在孕早期和幼儿中禁用。阿奇霉素是一种广泛使用的抗生素，具有抗疟作用，可替代甲氟喹作为一种新的抗疟方案。202例非复杂性恶性疟患者被随机分配到3种方案中的一种。第一组（n = 68）患者接受青蒿琥酯200 mg，每日1次，共3天；第二组（n = 67）患者在头2天接受青蒿琥酯200 mg与甲氟喹10 mg/kg联合用药，第3天接受青蒿琥酯200 mg与甲氟喹5 mg/kg联合用药；第三组（n = 67）患者接受青蒿琥酯200 mg与阿奇霉素50 mg联合用药，每日1次，共3天。28天治愈率分别为44%、98%和56%。第三组复发的中位时间明显更长。总之，青蒿琥酯和阿奇霉素联合用药可能对治疗可能同时伴有细菌和疟疾感染的儿童有用。然而，为了提高其临床疗效，还需要进一步开展工作。
