Comparison of the efficacy of artesunate-amodiaquine with quinine ... clindamycin for treatment of uncomplicated falciparum malaria in children

• Main Authors: Purnama Fitri, Armila Armila, Munar Lubis, Syahril Pasaribu, Chairuddin P. Lubis
• Format: Article
• Language: English
• Published: Indonesian Pediatric Society Publishing House 2009-04-01
• Series: Paediatrica Indonesiana
• Subjects: artesunate-amodiaquine; quinineclindamycin; uncomplicated falciparum malaria
• Online Access: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/533
• ISSN: 0030-9311; 2338-476X

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.