Efficacy of six doses of artemether-lumefantrine (benflumetol) in multidrug-resistant Plasmodium falciparum malaria.

M V Vugt Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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P Wilairatana Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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B Gemperli Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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I Gathmann Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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L Phaipun Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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A Brockman Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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C Luxemburger Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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N J White Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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F Nosten Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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S Looareesuwan Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand.

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The new oral fixed combination artemether-lumefantrine (CGP 56697) has proved to be an effective and well-tolerated treatment of multi-drug resistant Plasmodium falciparum malaria, although cure rates using the four-dose regimen have been lower than with the currently recommended alternative of artesunate-mefloquine. Two six-dose schedules (total adult dose = 480 mg of artemether and 2,880 mg of lumefantrine) were therefore compared with the previously used four-dose regimen (320 mg of artemether and 1,920 mg of lumefantrine) in a double-blind trial involving 359 patients with uncomplicated multidrug-resistant falciparum malaria. There were no differences between the three treatment groups in parasite and fever clearance times, and reported adverse effects. The two six-dose regimens gave adjusted 28-day cure rates of 96.9% and 99.12%, respectively, compared with 83.3% for the four-dose regimen (P < 0.001). These six-dose regimens of artemether-lumefantrine provide a highly effective and very well-tolerated treatment for multidrug-resistant falciparum malaria.

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