Comparison between efficacy of oral artemether 480mg and combination of oral artemether 480mg and mefloquine 1000mg in acute uncomplicated p. falciparum malaria

ABSTRACT

A prospective study comparing the efficacy of Artemether capsule (160 mg. tat and 80 mg. 12 hourly for four doses with a total dose of 480 mg.) as a single drug regimen and a combination drug regimen of Artemether capsule 480 mg. as above together with oral Mefloquine two equal split doses (500 mg 6 hours apart) was carried out at the No. 2, Military Hospital, Yangon during January 1993 and September, 1993. 30 patients were included in oral Artemether single drug regimen and 35 patients were included in oral Artemether and Mefloquine combination drug regimen. The mean age of two groups were 25.82 years and 25.37 years respectively. The initial parasite counts were 13736 and 16879 per microlitre respectively. All patients cleared the parasites initially in both groups. However, 12 patients (40 percent) recrudesced as RI cases in Artemether single drug regimen and thus cure rate was 60 percent. In combination drug regimen group 2 patients (5. 71 percent) recrudesced and cure rate was 94.29 percent. The parasite clearance time (PCT), fever clearance time (FCT) and 50 percent reduction time were compared in both groups and the results were 44.85*** 19.01 hours, 26.56*** 14.14 hours, 40.25*** 16.76 hours, 23.77*** 18.69 hours and 14.28*** 10.11 hours, 12.94*** 6.86 hours respectively. Significant side effects were not noted among patients in both groups. This study showed that Artemether capsule and Mefloquine combination drug regimen has higher efficacy interms of PCT, FCT and 50 percent reduction time than Artemether capsule single drug regimen for patients with acute uncomplicated falciparum malaria in Myanmar.