采用奎宁与甲氟喹或奎宁与乙胺嘧啶-磺胺多辛序贯治疗恶性疟。
Sequential treatment with quinine and mefloquine or quinine and pyrimethamine-sulfadoxine for falciparum malaria.
作者信息
Hall A P, Doberstyn E B, Karnchanachetanee C, Samransamruajkit S, Laixuthai B, Pearlman E J, Lampe R M, Miller C F, Phintuyothin P
出版信息
Br Med J. 1977 Jun 25;1(6077):1626-8. doi: 10.1136/bmj.1.6077.1626.
Patients with falciparum malaria were studied in Thailand, an area of known chloroquine resistance. The patients were unselected and some had severe malaria, and they were randomly assigned to one of two sequential regimes. A short course of quinine (average 4 doses, equivalent to 2 g base) followed by a single dose of pyrimethamine-sulfadoxine (Fansidar) cured 92% of patients (36 out of 39), while a short course of quinine followed by a single 1-5-dose of mefloquine cured all of the 35 patients who could be followed up. Gastrointestinal side effects were minimal if at least 12 hours elapsed between the last dose of quinine and the mefloquine. Sequential quinine and mefloquine is the most effective treatment for patients with chloroquine-resistant falciparum malaria, including those with severe or complicated disease. Mefloquine, however, is not commercially available, and the similar regimen using Fansidar is almost as effective.
在泰国这个已知存在氯喹抗性的地区，对恶性疟患者进行了研究。这些患者未经过挑选，部分患有严重疟疾，他们被随机分配到两种连续治疗方案中的一种。短疗程奎宁（平均4剂，相当于2克碱基）后接一剂乙胺嘧啶-磺胺多辛（Fansidar）治愈了92%的患者（39例中的36例），而短疗程奎宁后接一剂1 - 5剂的甲氟喹治愈了所有35例可进行随访的患者。如果在最后一剂奎宁和甲氟喹之间至少间隔12小时，胃肠道副作用极小。连续使用奎宁和甲氟喹是治疗氯喹抗性恶性疟患者（包括那些患有严重或复杂疾病的患者）最有效的方法。然而，甲氟喹没有商业供应，使用Fansidar的类似方案几乎同样有效。
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