Efficacy, safety and tolerability of three regimens of artemisinin combination therapy in the management of Plasmodium falciparum malaria: a comparative study
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20194148Keywords:
Plasmodium falciparum malaria, Artemisinin-based combination therapies, Febrile days, ThrombocytopeniaAbstract
Background: The WHO now recommends the use of artemisinin-based combination therapies for the first-line treatment of Plasmodium falciparum malaria to reduce the drug resistance. Hence, this study was designed to compare the efficacy, safety and tolerability of three regimens of artemisinin combination therapies in malaria diagnosed patients of Kamineni Institute of Medical Sciences Hospital, Narketpally.
Methods: Total of 104 subjects had been allocated to 3 different artemisinin-based combinations regimens in a period of 2 years during December 2013 - November 2015. Out of 104 subjects, 34 received artemisinin-sulphadoxine pyrimethamine regimen, 33 subjects received artemisinin-lumefantrine regimen, and 37 subjects received artemisinin-doxycycline regimen. All the three regimens were studied for their efficacy, safety and tolerability.
Results: The mean number of febrile days in artesunate-sulfadoxine pyrimethamine group (3.43±0.92) and artesunate-doxycycline group (3.51± 0.74) were comparatively less than artemether-lumefantrine group (4.33±0.77) which is statistically significant. The mean Hb%, RBC count, WBC count was not significantly different on day 7 in comparison to day 1 in all the three regimens of treatment groups. 14 subjects among the 104 had mild thrombocytopenia which was significantly improved on day 7 in all the three regimens of treatment groups.
Conclusions: Artesunate-sulfadoxine-pyrimethamine and artesunate-doxycycline regimens showed better efficacy, safety and tolerability than artemether-lumefantrine regimen.
Metrics
References
Kasper DL, Braunwalg E, Anthony S, Fauci, Stephen L, Hauser, editors. Harrison’s Principles of Internal Medicine. 19th ed. The McGraw-Hill (New York); 2015: 1368-1371.
WHO. “World malaria report”: A document of World Health Organization, Geneva. 2018.
Kimbi HK, Ntoko M, Ntonifor NN, Lum E, Njunda AL, Fon PN. Efficacy and Tolerability of Malartin and Sulphadoxine-Pyrimethamine Combination against Uncomplicated Falciparum Malaria in Dibanda, Southwest Cameroon. J Trop Med. 2012;372518:7.
Sharma HL, Sharma KK, Principles of pharmacology. 3rd ed. New Delhi: Paras Medical Publisher; 2017: 824-837.
Mukhtar EA, Gadalla NB, El-zaki SE, Mukhtar I, Mansour FA, Babiker A, et al. A comparative study on the efficacy of artesunate plus sulphadoxine/ pyrimethamine versus artemether-lumefantrine in eastern Sudan. Malar J. 2007;6:92.
WHO. Antimalarial drug combination therapy. Report of a WHO Technical Consultation,” Report of a WHO Technical Consultation WHO/CDS/RBM/ 2001, WHO, Geneva, Switzerland, 2001.
Park K. Park’s textbook of preventive and social medicine. 23rd ed. India: Bhanot Publishers; 2015: 256-260.
Brunton LL, Chabner BA, Knollaman BC. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 12th ed. New York: McGraw-Hill; 2012: 1383-1399.
Elamin SB, Malik EM, Abdelgadir T, Khamiss AH, Mohammed MM, Ahmed ES, et al. Artesunate plus sulfadoxine-pyrimethamine for treatment of uncomplicated Plasmodium falciparum malaria in Sudan. Malar J. 2005;4:41.
Mockenhaupt FP, Ehrhardt S, Dzisi SY, Teun Bousema J, Wassilew N, Schreiber J, et al. A randomized, placebo-controlled, double-blind trial on sulfadoxine- pyrimethamine alone or combined with artesunate or amodiaquine in uncomplicated malaria. Trop Med Int Health. 2005;10(6):512-20.
Marquiño W, Ylquimiche L, Hermenegildo Y, Palacios AM, Falconí E, Cabezas C, et al. Efficacy and tolerability of artesunate plus sulfadoxine-pyrimethamine and sulfadoxine-pyrimethamine alone for the treatment of uncomplicated Plasmodium falciparum malaria in Peru. Am J Trop Med Hyg. 2005;72(5):568-72.
Downloads
Published
How to Cite
Issue
Section
