Karwacki J J, Shanks G D, Limsomwong N, Singharaj P
Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Trans R Soc Trop Med Hyg. 1990 Jan-Feb;84(1):55-7. doi: 10.1016/0035-9203(90)90380-w.
There are few safe, effective chemoprophylactic regimens for preventing Plasmodium falciparum infection in south-east Asia. In two randomized placebo-controlled trials, combinations of proguanil and sulphonamide were tested for chemoprophylactic activity in schoolchildren, aged 6-15 years, living near the Thai-Burmese border. Proguanil at an equivalent adult dose of 200 mg/d was combined with sulphafurazole (= sulfisoxazole) at 25 mg/kg/d or sulphamethoxazole at 25 and 10 mg/kg/d. Combinations of daily proguanil/sulphafurazole and proguanil/sulphamethoxazole were equally effective (greater than 75%) against both falciparum and vivax malaria when the sulphonamide component was used at 25 mg/kg/d. Proguanil and sulphamethoxazole at 10 mg/kg/d was ineffective. Approximately 1% of the children had sulphonamide-related skin rashes which resolved when treatment stopped. Proguanil/sulphonamide is a possible alternative chemoprophylactic regimen in areas with multiple drug-resistant P. falciparum.
在东南亚，几乎没有安全、有效的化学预防方案来预防恶性疟原虫感染。在两项随机安慰剂对照试验中，对居住在泰缅边境附近的6至15岁学童测试了氯胍与磺胺类药物的组合的化学预防活性。氯胍以相当于成人剂量200mg/d与磺胺异恶唑以25mg/kg/d或磺胺甲恶唑以25mg/kg/d和10mg/kg/d联合使用。当磺胺类药物成分以25mg/kg/d使用时，每日氯胍/磺胺异恶唑和氯胍/磺胺甲恶唑组合对恶性疟和间日疟同样有效（大于75%）。氯胍和10mg/kg/d的磺胺甲恶唑无效。约1%的儿童出现与磺胺类药物相关的皮疹，停药后皮疹消退。在多重耐药恶性疟原虫流行地区，氯胍/磺胺类药物是一种可能的替代化学预防方案。
