Institut de Médecine Tropicale du Service de Santé des Armées, BP 46, 13998 Marseille Armées, France.
Trans R Soc Trop Med Hyg. 2010 Apr;104(4):290-7. doi: 10.1016/j.trstmh.2009.10.001. Epub 2010 Feb 2.
Failures of malaria chemoprophylaxis have been related to a lack of compliance with doxycycline due to its short elimination half-life. Adding a molecule with a long half-life to doxycycline could be useful to take over from this drug in case of occasional missed doses. A double-blind, placebo-controlled randomized field trial was designed to compare the tolerability of a doxycycline-chloroquine combination vs. doxycycline as malaria prophylaxis among French soldiers deployed in Africa. Data from 936 volunteers were analyzed. In both groups, the proportion of volunteers who reported at least one adverse effect was about 57%. Tolerability was similar in the groups except for a higher proportion of nausea or vomiting in the doxycycline-chloroquine group. The reported compliance rate was 86.6% and was similar in the two groups. Eight Plasmodium falciparum malaria cases were diagnosed in the doxycycline group and seven in the doxycycline-chloroquine group. The efficacy of the two chemoprophylaxis regimens was similar. Our study was the first randomized field trial to assess a doxycycline-chloroquine combination as malaria prophylaxis and showed no significant decrease of overall tolerability of the combination compared with doxycycline alone. Our results showed that a doxycycline-chloroquine combination could be a safe combination for malaria chemoprophylaxis.
由于强力霉素半衰期短，其使用时不遵医嘱导致了疟疾化学预防失败。在强力霉素中加入半衰期长的分子，可在偶尔漏服药物时替代该药物。设计了一项双盲、安慰剂对照随机现场试验，以比较在非洲部署的法国士兵中，强力霉素-氯喹联合用药与强力霉素作为疟疾预防的耐受性。对 936 名志愿者的数据进行了分析。在这两组中，报告至少有一次不良反应的志愿者比例约为 57%。两组的耐受性相似，但强力霉素-氯喹组恶心或呕吐的比例较高。报告的依从率为 86.6%，两组相似。在强力霉素组诊断出 8 例恶性疟原虫疟疾，在强力霉素-氯喹组诊断出 7 例。两种化学预防方案的疗效相似。我们的研究是第一项评估强力霉素-氯喹联合用药作为疟疾预防的随机现场试验，与单独使用强力霉素相比，联合用药的总体耐受性没有显著下降。我们的结果表明，强力霉素-氯喹联合用药可能是一种安全的疟疾化学预防药物。
