Artesunate plus mefloquine versus mefloquine for treating uncomplicated malaria

Abstract

Artesunate plus mefloquine performs better than mefloquine alone for treating uncomplicated falciparum malaria in areas with low malaria transmission. A total dose of 25 mg/kg mefloquine and at least 10 mg artesunate leads to higher cure rates. Better reporting of methods and standardisation of outcomes would help the interpretation of future trials.

Are national treatment guidelines for falciparum malaria in line with WHO recommendations and is antimalarial resistance taken into consideration? – A review of guidelines in non‐endemic countries

“…Atovaquone–proguanil has fewer adverse effects than quinine but is also less effective than ACTs and should therefore not be a first‐line treatment [ 33 , 34 ]. Three of four countries recommending mefloquine as one of the treatment options do so as a monotherapy, while its efficacy is significantly better when combined with artesunate [ 1 , 35 ]. The United States of America differentiates between chloroquine‐sensitive and ‐resistant forms of Plasmodium falciparum , as chloroquine‐sensitive Plasmodium falciparum is still endemic in parts of Latin America.…”

Are national treatment guidelines for falciparum malaria in line with WHO recommendations and is antimalarial resistance taken into consideration? – A review of guidelines in non‐endemic countries

“…Atovaquone–proguanil has fewer adverse effects than quinine but is also less effective than ACTs and should therefore not be a first‐line treatment [ 33 , 34 ]. Three of four countries recommending mefloquine as one of the treatment options do so as a monotherapy, while its efficacy is significantly better when combined with artesunate [ 1 , 35 ]. The United States of America differentiates between chloroquine‐sensitive and ‐resistant forms of Plasmodium falciparum , as chloroquine‐sensitive Plasmodium falciparum is still endemic in parts of Latin America.…”

Defining a standard medication kit for prehospital and retrieval physicians: a comprehensive review

“…Some good quality evidence for the treatment of severe malaria supports intravenous artesunate in combination with mefloquine as being superior to older regimes 116 122 123…”

Diagnosis and management of malaria in the intensive care unit

“…Some pharmacokinetic changes such as reduced gastrointestinal motility, changes in total body water and fat content, and increased plasma volume in pregnancy may alter the absorption and distribution resulting in low serum concentrations of artesunate, artemether, and DHA in pregnant women. [ 129 , 130 ] However, artemisinin-based combination therapies (ACTs) are recommended as first-line antimalarials by WHO for managing uncomplicated malaria in the second and third trimesters of pregnancy. [ 131 ] …”

Are national treatment guidelines for falciparum malaria in line with WHO recommendations and is antimalarial resistance taken into consideration? – A review of guidelines in non‐endemic countries

“…Atovaquone–proguanil has fewer adverse effects than quinine but is also less effective than ACTs and should therefore not be a first‐line treatment [ 33 , 34 ]. Three of four countries recommending mefloquine as one of the treatment options do so as a monotherapy, while its efficacy is significantly better when combined with artesunate [ 1 , 35 ]. The United States of America differentiates between chloroquine‐sensitive and ‐resistant forms of Plasmodium falciparum , as chloroquine‐sensitive Plasmodium falciparum is still endemic in parts of Latin America.…”

Defining a standard medication kit for prehospital and retrieval physicians: a comprehensive review

“…Some good quality evidence for the treatment of severe malaria supports intravenous artesunate in combination with mefloquine as being superior to older regimes 116 122 123…”

Diagnosis and management of malaria in the intensive care unit

“…Some pharmacokinetic changes such as reduced gastrointestinal motility, changes in total body water and fat content, and increased plasma volume in pregnancy may alter the absorption and distribution resulting in low serum concentrations of artesunate, artemether, and DHA in pregnant women. [ 129 , 130 ] However, artemisinin-based combination therapies (ACTs) are recommended as first-line antimalarials by WHO for managing uncomplicated malaria in the second and third trimesters of pregnancy. [ 131 ] …”

Are national treatment guidelines for falciparum malaria in line with WHO recommendations and is antimalarial resistance taken into consideration? – A review of guidelines in non‐endemic countries

“…Atovaquone–proguanil has fewer adverse effects than quinine but is also less effective than ACTs and should therefore not be a first‐line treatment [ 33 , 34 ]. Three of four countries recommending mefloquine as one of the treatment options do so as a monotherapy, while its efficacy is significantly better when combined with artesunate [ 1 , 35 ]. The United States of America differentiates between chloroquine‐sensitive and ‐resistant forms of Plasmodium falciparum , as chloroquine‐sensitive Plasmodium falciparum is still endemic in parts of Latin America.…”

Defining a standard medication kit for prehospital and retrieval physicians: a comprehensive review

“…Some good quality evidence for the treatment of severe malaria supports intravenous artesunate in combination with mefloquine as being superior to older regimes 116 122 123…”

Diagnosis and management of malaria in the intensive care unit

“…Some pharmacokinetic changes such as reduced gastrointestinal motility, changes in total body water and fat content, and increased plasma volume in pregnancy may alter the absorption and distribution resulting in low serum concentrations of artesunate, artemether, and DHA in pregnant women. [ 129 , 130 ] However, artemisinin-based combination therapies (ACTs) are recommended as first-line antimalarials by WHO for managing uncomplicated malaria in the second and third trimesters of pregnancy. [ 131 ] …”