ABSTRACT
Comparative treatment of ivermectin in 21 patients (Group 1) and albendazole in 49 patients (Group 2) of gnathostomiasis gave the cure at 95.2% and 93.8% respectively. The ELISA OD and eosinophil counts were reduction after treatment. Side effects in ivermectin were hypotention, dizziness, weakness and diuresis; and side effects of albendazole were nausia, dizziness and increased alkaline phosphatase in two cases. Ivermectin should be an effective drug againts gnathostomiasis and more convenient in treatment single dose.
Subject(s)
Adolescent , Adult , Albendazole/adverse effects , Animals , Antinematodal Agents/adverse effects , Child , Eosinophils , Female , Gnathostoma , Humans , Ivermectin/adverse effects , Leukocyte Count , Male , Middle Aged , Spirurida Infections/drug therapyABSTRACT
The difficulties in treating drug-resistant falciparum malaria in Thailand are compounded by the necessity of giving antimalarials over long periods of time. The resultant fall in patient compliance not only lowers cure rates but also predisposes to the further spread of drug-resistance. Sequential treatment with artesunate given over 5 days followed by mefloquine produced 100% cure rates in previous study, but might not be a suitable regimen for field treatment. We conducted a clinical trial of a combination of artesunate and mefloquine given twice daily for 2 days in 150 patients with acute uncomplicated falciparum malaria. The dose of artesunate (200 mg) and mefloquine (312.5 mg) were given simultaneously in a separate package. All patients were admitted to a hospital in Bangkok for 28 days to exclude re-infection and monitor the possible adverse effects. One hundred and thirty patients completed the study with 28 days follow up. Twenty patients (13%) left the hospital prior to completion of follow-up for reasons unrelated to their treatment. Cure rate was 97% (126/130). There were no RII or RIII failures and all four patients with treatment failures were of the RI type. The mean parasite clearance time and fever clearance time were 46.4 and 42.5 hours, respectively. All patients were tolerated the combination drugs well and there were no serious toxic adverse reactions. The results indicate that combination of artesunate and mefloquine given twice daily for 2 days is effective and well tolerated in patients with acute, uncomplicated falciparum malaria and suitable as an alternative treatment for multidrug resistant falciparum malaria.