The Effect of oral artesunate versus quinine on patients who are resistant to chloroquine and sulfadoxine pyrimethamine

ABSTRACT

The patients who attended the out patients cllinic of Thayarwaddy Civil Hospital and North Okkalapa General Hospital were treated with chloroquine (600 mg base at days 0 and 1 and 300 mg base at day 2). To those who failed to clear the parasites at 72 hours were treated with 3 tablets of sulfadoxine pyrimethamine (each containing 500 mg sulfadoxine and 25 mg pyrimethamine). To those who failed again to clear the parasites at 72 hours were treated with one of the following drugs at alternate sequence. (1) 50 mg Artesunate tablets were given twice a day for 5 days orally. The initial dose was double. (2) Quinine sulphate tablets 600 mg 3 times per day given orally for 7 days. Total 60 patients were studied.In both groups of patients parasites were cleared at 72 hours and at day 4. The parasite clearance time and fever clearance time of the patients treated with the two different drugs were not statistically different. All patients treated with artesunate can tolerate the drug and were free from side effects that can be related to the drug. Out of 18 patients who were followed till day 28,6 patients recrudesced at days between 21 and 28. Among the patients treated with quinine 50 percent failed to complete the drug course. Out of 10 patients who were followed till day 28, one patient recrudesced at day 21. We conclude that Artesunate or quinine alone are effective but may not be useful for treatment of drug resistant malaria.