Comparison of the efficacy of artesunate-amodiaquine with quinine-clindamycin for treatment of uncomplicated falciparum malaria in children
Abstract
Background Drug-resistant Plasmodium falciparum malaria is a
major contributor to increasing malaria-related morbidity and
mortality. Artesunate-amodiaquine is a potential combination
therapy that shows improved treatment efficacy. Clindamycin in
combination with quinine is also a safe and effective treatment
for multidrug-resistant P. falciparum malaria.
Objectives To compare the efficacy of artesunate-amodiaquine and
quinine-clindamycin combination therapies for the treatment of
uncomplicated falciparum malaria.
Methods This randomized open label trial in 23 2 children aged
between one month and 18 years old took place in Mandailing
Natal, North Sumatra, from August to September 2006. The AA
group received a 3-day oral course of artesunate (4 mg/kg BW
once a day) plus amodiaquine (10 mg/kg BW once a day). The
QC group received a 3-day course of clindamycin (5 mg of base/kg
BW twice a day) plus a 7-day course of quinine (10 mg of salt/kg
BW orally for the first four days, then 5 mg of quinine salt/kg BW
for the next three days). We performed thin and thick peripheral
blood smears on days 0, 2, 7, and 28.
Results A total of 232 eligible children were enrolled but only
22 7 completed the study (114 in group AA, 113 in group QC).
The cure rates were lOOo/o in both groups by the second day, and
there was no recrudescence in either group. We found more side
effects in AA group compared with in QC group, i.e., headache
and vomiting.
Conclusion Artesunate-amodiaquine and quinine-clindamycin
combinations showed similar efficacy for the treatment of uncomplicated
P. falciparum.
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Accepted 2016-09-10
Published 2009-04-30
