Comparing the efficacy of mefloquine-artesunate combination with that of mefloquine and artesunate as single agents in uncomplicated falciparum malaria

ABSTRACT

To find out whether the combination regimen of mefloquine and artesunate tablets improves the cure rate in uncomplicated falciparum malaria compared to the use of mefloquine and artesunate as single agents, a prospective, randomised, uniblind controlled study was done between May and November 1991, on one hundred and eighty cases of acute uncomplicated falciparum malaria. The patients were randomised to the following three frug regimens - (1) Mefloquine - 1000 mg stat, (2) Tab Artesunate 600 mg over 48 hours, (3) Mefloquine 1000 mg plus tab Artesunate 600 mg over 48 hours. The regimen of mefloquine as a single agent gave a cure rate of 83.3 percent (with R1 = 15 percent and R2 = 1.7 percent), PCT = 52.15 + 55.2 hours and FCT = 23.98 + 59.87 hours. Tab artesunate gave a cure rate of 75 percent (with R1 = 25 percent), PCT = 33.16 + 5.15 and FCT = 23.4 + 22.7 hours. The combination regimen gave a cure rate of 98.27 percent with only one patient recrudescing at R1 level, PCT = 35.11 + 29.16 and FCT = 8.15 + 10.34 hours. The side effects were not much increased by using the combination. No cardiovascular effects were noted. The combination is superior to that of the single agents.