The Efficacy of Halofantrine in the Treatment of Acute Malaria in Nonimmune Travelers

Thomas WeinkeUniversitatsklinikum Rudolf Virchow, II Medizinische Klinik, Abteilung fur Infektions und Tropenmedizin der Universitat, Missionsarztliche Klinik, Tropenmedizin, Tropenklinik Paul-Lechler-Krankenhaus, Smith Kline Beecham, Klinische Forschung, Berlin, Germany

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Thomas LoscherUniversitatsklinikum Rudolf Virchow, II Medizinische Klinik, Abteilung fur Infektions und Tropenmedizin der Universitat, Missionsarztliche Klinik, Tropenmedizin, Tropenklinik Paul-Lechler-Krankenhaus, Smith Kline Beecham, Klinische Forschung, Berlin, Germany

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Klaus FleischerUniversitatsklinikum Rudolf Virchow, II Medizinische Klinik, Abteilung fur Infektions und Tropenmedizin der Universitat, Missionsarztliche Klinik, Tropenmedizin, Tropenklinik Paul-Lechler-Krankenhaus, Smith Kline Beecham, Klinische Forschung, Berlin, Germany

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Harald KretschmerUniversitatsklinikum Rudolf Virchow, II Medizinische Klinik, Abteilung fur Infektions und Tropenmedizin der Universitat, Missionsarztliche Klinik, Tropenmedizin, Tropenklinik Paul-Lechler-Krankenhaus, Smith Kline Beecham, Klinische Forschung, Berlin, Germany

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Hans D. PohleUniversitatsklinikum Rudolf Virchow, II Medizinische Klinik, Abteilung fur Infektions und Tropenmedizin der Universitat, Missionsarztliche Klinik, Tropenmedizin, Tropenklinik Paul-Lechler-Krankenhaus, Smith Kline Beecham, Klinische Forschung, Berlin, Germany

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Bernd KohlerUniversitatsklinikum Rudolf Virchow, II Medizinische Klinik, Abteilung fur Infektions und Tropenmedizin der Universitat, Missionsarztliche Klinik, Tropenmedizin, Tropenklinik Paul-Lechler-Krankenhaus, Smith Kline Beecham, Klinische Forschung, Berlin, Germany

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Thomas SchlunkUniversitatsklinikum Rudolf Virchow, II Medizinische Klinik, Abteilung fur Infektions und Tropenmedizin der Universitat, Missionsarztliche Klinik, Tropenmedizin, Tropenklinik Paul-Lechler-Krankenhaus, Smith Kline Beecham, Klinische Forschung, Berlin, Germany

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Ralf ClemensUniversitatsklinikum Rudolf Virchow, II Medizinische Klinik, Abteilung fur Infektions und Tropenmedizin der Universitat, Missionsarztliche Klinik, Tropenmedizin, Tropenklinik Paul-Lechler-Krankenhaus, Smith Kline Beecham, Klinische Forschung, Berlin, Germany

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Hans L. BockUniversitatsklinikum Rudolf Virchow, II Medizinische Klinik, Abteilung fur Infektions und Tropenmedizin der Universitat, Missionsarztliche Klinik, Tropenmedizin, Tropenklinik Paul-Lechler-Krankenhaus, Smith Kline Beecham, Klinische Forschung, Berlin, Germany

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A multicenter prospective trial was performed to investigate the efficacy and the tolerability of halofantrine in nonimmune patients with malaria imported from areas with drug-resistant falciparum parasites (mainly Africa). Forty-five of the 74 subjects were treated with a one-day regimen (3 × 500 mg) of halofantrine, and the other 29 received the same regimen with an additional treatment on day 7. In the second group, a 100% efficacy rate was demonstrated, but in the group receiving the one-day regimen, four recrudescences were observed in patients with falciparum malaria. Only five mild adverse reactions were seen, which disappeared spontaneously after the end of the treatment. We conclude that halofantrine is highly effective in curing malaria in nonimmune subjects. The treatment scheme for such persons should include an additional treatment on day 7 for nonimmune individuals. This drug was well tolerated in our patients, indicating that halofantrine will be useful in the treatment of multidrug-resistant malaria in nonimmune persons.

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