Goerg H, Ochola S A, Goerg R
Akado Development Women's Group (NGO), Mbita, Kenya.
Chemotherapy. 1999 Jan-Feb;45(1):68-76. doi: 10.1159/000007167.
The treatment of malaria tropica is becoming difficult because of the increasing drug resistance rates of Plasmodium falciparum against several of the currently available antimalarias. A fixed combination of rifampicin, co-trimoxazole and isoniazid (CotrifazidTM, CF) was found to be highly effective for the treatment of malaria tropica. The aim of the present study in Kenya was to scrutinize this finding in a 14-day trial. Patients with malaria tropica were given in an open, double-arm randomized study CF for 5 days, or chloroquine or pyrimethamine/sulphadoxine as the control. Because of an apparently better activity and tolerance of CF, the randomization had to be stopped after the enrollment of 50 patients. A total of 61 patients in both groups (35 of them between 2 months and 6 years of age) were available for final analysis. All 41 patients treated with CF, originally positive in their blood smears, turned negative; in 2 cases blood smear positivity reappeared on day 14. There were 7 failures in the control group, 4 of them a primary one. Four of those failures were turned negative with CF, 2 failed with CF also, and 1 disappeared. The tolerance of CF was excellent even in infants. In our experience, CF is very well suited for the treatment of malaria tropica, also in cases of apparent drug resistance of P. falciparum against other antimalarials, and even in severe cases of the disease.
由于恶性疟原虫对目前几种可用抗疟药物的耐药率不断上升，热带疟疾的治疗正变得愈发困难。研究发现，利福平、复方新诺明和异烟肼的固定组合（CotrifazidTM，CF）对热带疟疾的治疗非常有效。本研究在肯尼亚开展的目的是，在一项为期14天的试验中仔细检验这一发现。在一项开放性双臂随机研究中，给热带疟疾患者服用CF 5天，或使用氯喹或乙胺嘧啶/磺胺多辛作为对照。由于CF的活性和耐受性明显更好，在招募了50名患者后不得不停止随机分组。两组共有61名患者（其中35名年龄在2个月至6岁之间）可供最终分析。所有41名接受CF治疗的患者，最初血涂片呈阳性，后来均转为阴性；有2例在第14天血涂片再次出现阳性。对照组有7例治疗失败，其中4例为初次治疗失败。这些失败病例中有4例经CF治疗后转为阴性，2例用CF治疗也失败，1例消失。CF的耐受性极佳，即使对婴儿也是如此。根据我们的经验，CF非常适合治疗热带疟疾，即使在恶性疟原虫对其他抗疟药物明显耐药的情况下，甚至在该病的严重病例中也是如此。
