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SUCCESSFUL TREATMENT OF PLASMODIUM FALCIPARUM MALARIA WITH A SIX-DOSE REGIMEN OF ARTEMETHER-LUMEFANTRINE VERSUS QUININE-DOXYCYCLINE IN THE WESTERN AMAZON REGION OF BRAZIL

This randomized, open-label study compared a three-day, six-dose regimen of artemether-lumefantrine with a five-day, 19-dose regimen of quinine-doxycycline for the treatment of Plasmodium falciparum malaria in the western Amazon region of Brazil. All patients remained hospitalized during their treatment and the study assessments were scheduled daily from the start of treatment (day 0) through day 6. By day 3, the percentage of infected patients was 0% in the artemether-lumefantrine group and 48.8% in the quinine-doxycycline group. Median parasite clearance time was significantly shorter in the artemether-lumefantrine group (two days) compared with the quinine-doxycycline group (three days) (P < 0.0001). Two patients in the quinine-doxycycline group left the study early because of treatment ineffectiveness or adverse event. Adverse events were reported by 91.5% of the study participants, most of which were mild in severity and/or not considered related to study treatment. Artemether-lumefantrine was shown to be an efficacious, safe, and convenient treatment for P. falciparum malaria in a highly drug-resistant region of South America.

Received June 24, 2004. Accepted for publication May 19, 2005.

Acknowledgments: We thank all patients for their willingness to participate in the study.

Financial support: This study was supported by Novartis.

Disclosure: The research published in the report was sponsored by Novartis. This statement is made in the interest of full disclosure and not because the authors consider this to be a conflict of interest.

^* Address correspondence to Marcus V. Lacerda, Laboratory of Malaria, Tropical Medicine Foundation of Amazonas, Av. Pedro Teixeira, 25, Manaus, Amazonas, Brazil. 69.040-000, E-mail: marcuslacerda{at}uol.com.br

Authors’ addresses: Maria G. Alecrim, Marcus V. Lacerda, Maria P. Mourão, and Wilson D. Alecrim, Centro Universitário Nilton Lins, UNICENTER, Sala 315, Av. Professor Nilton Lins, 3259, Parque das Laranjeiras/Flores, Manaus, Amazonas, Brazil, 69.058-040, E-mails: malecrim{at}niltonlins.br, marcuslacerda{at}uol.com.br, mpmourao{at}uol.com.br, and walecrim{at}uol.com.br. Alexandre Padilha, Bernardo S. Cardoso, and Marcos Boulos, University of São Paulo Tropical Medicine Advanced Center, Santarém, Pará, Brazil, E-mail: mboulos{at}usp.br.

Reprint requests: Marcus V. Lacerda, Laboratory of Malaria, Tropical Medicine Foundation of Amazonas, Av. Pedro Teixeira, 25, Manaus, Amazonas, Brazil, 69.040-000, E-mail: marcuslacerda{at}uol.com.br.

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				M. d. G. C. Alecrim, M. V. G. de Lacerda, M. P. G. Mourao, W. D. Alecrim, A. Padilha, B. Cardoso, and M. Boulos Letter to the editor. Am J Trop Med Hyg, August 1, 2006; 75(2): 187 - 187. [Full Text] [PDF]