Khaliq A A, Fox E, Sarwar M, Strickland G T
Clinical Epidemiology Department, International Centre for Medical Research & Training, Lahore, Pakistan.
Trans R Soc Trop Med Hyg. 1987;81(1):157-9. doi: 10.1016/0035-9203(87)90311-7.
We evaluated amodiaquine as a replacement drug for treating falciparum malaria in an area of Pakistani Punjab where chloroquine-resistant Plasmodium falciparum has recently emerged. Amodiaquine appeared to be 4 to 8 times more effective than chloroquine when P. falciparum isolates were tested in vitro. However, the recrudescence rate was greater than 50% after oral treatment with 20 mg/kg amodiaquine given over two successive days. This lack of therapeutic response from amodiaquine may have been due to selection of resistant parasites in the villages where the study was performed through extensive use of chloroquine for presumptive malaria treatment during the preceding 18 months. We conclude that amodiaquine is not a suitable replacement for chloroquine for treating falciparum malaria in our study area despite in vitro sensitivity data suggesting that it would be efficacious. Baseline in vitro sensitivity to mefloquine is also reported.
在巴基斯坦旁遮普省的一个地区，恶性疟原虫对氯喹已产生耐药性，我们在此评估了阿莫地喹作为治疗恶性疟疾替代药物的效果。在体外对恶性疟原虫分离株进行测试时，阿莫地喹的效果似乎比氯喹高4至8倍。然而，连续两天口服20mg/kg阿莫地喹进行治疗后，复发率超过了50%。阿莫地喹治疗效果不佳可能是由于在研究开展的村庄中，在前18个月广泛使用氯喹进行推定疟疾治疗，从而选择出了耐药寄生虫。我们得出结论，尽管体外敏感性数据表明阿莫地喹有效，但在我们的研究区域，它并非治疗恶性疟疾的氯喹合适替代品。本文还报告了甲氟喹的基线体外敏感性。
