阿奇霉素与青蒿琥酯联合治疗或奎宁治疗无并发症恶性疟原虫疟疾在成人:一项随机,在泰国2期临床试验。
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Noedl H, Krudsood年代,Chalermratana K, Silachamroon U, Leowattana W, Tangpukdee N, Looareesuwan年代,米勒RS,福田M, Jongsakul K, Sriwichai年代,罗文J, Bhattacharyya H, Ohrt C, Knirsch C
阿奇霉素与青蒿琥酯联合治疗或奎宁治疗无并发症恶性疟原虫疟疾在成人:一项随机,在泰国2期临床试验。
感染说。2006年11月15日,43 (10):1264 - 71。Epub 2006年10月12日。
- PubMed ID
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17051490 (在PubMed]
- 文摘
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背景:由于对抗疟药物的耐药性蔓延,人们迫切需要新的组合治疗疟疾,杀死> 100万人每年。阿奇霉素是一种大环内脂类抗菌素,作为抗疟格外具有吸引力,因为其安全的儿童和怀孕期间使用的丰富经验。方法:我们进行了一项随机、对照,28天住院审判涉及患者急性无并发症恶性疟原虫疟疾。我们比较的安全性和有效性2成人和2 azithromycin-quinine azithromycin-artesunate组合方案和疟疾。治疗如下:队列1收到3天的阿奇霉素(750毫克每日两次)+青蒿琥酯(100毫克每日两次),组2收到3天的阿奇霉素(1000毫克每日一次)+青蒿琥酯(200毫克每日一次),组3收到3天的阿奇霉素(750毫克每日两次)+奎宁每天两次(10毫克/公斤),和群组4收到3天的阿奇霉素(500毫克,每日3次)+奎宁(10毫克/公斤每天3次)。招生的目标是25每组可评价的对象。结果:28天治愈率是同样高的青蒿琥酯和标准剂量奎宁军团:92.0%(95%可信区间(CI), 74.0% - -99.0%), 88.9%(95%可信区间,70.8% -97.6%)和92.0%(95%可信区间,74.0% -99.0%),组1、2和4分别。R1后期治疗失败被认为在每个青蒿琥酯和标准剂量奎宁军团。3组的治愈率为73.3%(95%可信区间,44.9% -92.2%)。在这一群人,3早期治疗失败导致终止16个受试者被录取后入学。 With mean parasite and fever clearance times (+/-SD) of 34+/-13 h and 20+/-20 h, the artesunate combinations were found to have led to a significantly (P<.001) faster clinical and parasitological improvement than occurred in the quinine cohorts (74+/-32 h and 43+/-37 h, respectively). Treatment-related adverse events were significantly more common in the quinine cohorts (P<.001). No deaths or drug-related serious adverse events were observed. In vitro results suggest that the treatment failures--particularly in the low-dose quinine cohort--were associated with decreased susceptibility to quinine, as well as with mefloquine cross-resistance. CONCLUSIONS: These data suggest that azithromycin-artesunate, even when given only once daily for 3 days, and azithromycin-quinine, given 3 times daily, are safe and efficacious combination treatments for uncomplicated falciparum malaria, and they deserve additional study in special patient populations.
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- 药物