Heymann D L, Khoromana C O, Wirima J J, Campbell C C
Combatting Childhood Communicable Diseases Program, Ministry of Health, Malawi.
Trans R Soc Trop Med Hyg. 1987;81(5):722-4. doi: 10.1016/0035-9203(87)90005-8.
In Malawi, where high levels of chloroquine resistance were shown using a modified 7-day in vivo test, amodiaquine and pyrimethamine-sulfadoxine were evaluated as alternative initial therapies for Plasmodium falciparum infections in children under 5 years old. Therapy success rates, judged by parasite clearance by day 7 after initiation of therapy, were significantly greater among 39 children treated with amodiaquine at 10 mg/kg (90%), 37 receiving amodiaquine at 25 mg/kg (97%), and 34 receiving pyrimethamine-sulfadoxine (100%) at a dose of 25 mg sulfadoxine/kg, than among those treated with chloroquine at a dose of 25 mg/kg (59%) (P = 0.01). Extension of the follow-up period of those receiving amodiaquine (25 mg/kg) and pyrimethamine-sulfadoxine to 21 d revealed a progressively increasing rate of parasite recrudescence in the amodiaquine group (34%), but no recrudescence in the pyrimethamine-sulfadoxine group. These results suggest that, in Malawi, amodiaquine and pyrimethamine-sulfadoxine are superior to chloroquine in producing prompt clearance of P. falciparum parasites among young children, and that pyrimethamine-sulfadoxine alone is superior to the 4-aminoquinolines in sustaining P. falciparum clearance.
在马拉维，采用改良的7天体内试验显示氯喹耐药性水平很高，于是对阿莫地喹和乙胺嘧啶-磺胺多辛作为5岁以下儿童恶性疟原虫感染的替代初始疗法进行了评估。以治疗开始后第7天的寄生虫清除情况判断，治疗成功率在39名接受10毫克/千克阿莫地喹治疗的儿童中显著更高（90%），37名接受25毫克/千克阿莫地喹治疗的儿童中（97%），以及34名接受25毫克磺胺多辛/千克乙胺嘧啶-磺胺多辛治疗的儿童中（100%），高于接受25毫克/千克氯喹治疗的儿童（59%）（P = 0.01）。将接受阿莫地喹（25毫克/千克）和乙胺嘧啶-磺胺多辛治疗的儿童随访期延长至21天，结果显示阿莫地喹组寄生虫复发率逐渐上升（34%），但乙胺嘧啶-磺胺多辛组无复发情况。这些结果表明，在马拉维，阿莫地喹和乙胺嘧啶-磺胺多辛在促使幼儿恶性疟原虫寄生虫快速清除方面优于氯喹，且单独使用乙胺嘧啶-磺胺多辛在维持恶性疟原虫清除方面优于4-氨基喹啉。
