Drug Administration Schedule

Publication Title: 
British Journal of Clinical Pharmacology

PURPOSE: To characterize artemisinin pharmacokinetics (PK) and its antimalarial activity in vivo. METHODS: Artemisinin salivary concentration and parasite count data were obtained from Vietnamese malaria patients receiving two different dosage regimens. PK data were analysed using a previously developed semiphysiological model incorporating autoinduction of eliminating enzymes. A pharmacodynamic (PD) model reflecting different stages of the parasite life-cycle was developed and fitted to the data.

Author(s): 
Gordi, Toufigh
Xie, Rujia
Jusko, William J.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

This randomized, open-label study compared a three-day, six-dose regimen of artemether-lumefantrine with a five-day, 19-dose regimen of quinine-doxycycline for the treatment of Plasmodium falciparum malaria in the western Amazon region of Brazil. All patients remained hospitalized during their treatment and the study assessments were scheduled daily from the start of treatment (day 0) through day 6. By day 3, the percentage of infected patients was 0% in the artemether-lumefantrine group and 48.8% in the quinine-doxycycline group.

Author(s): 
Alecrim, Maria G.
Lacerda, Marcus V.
Mourão, Maria P.
Alecrim, Wilson D.
Padilha, Alexandre
Cardoso, Bernardo S.
Boulos, Marcos
Publication Title: 
Tropical medicine & international health: TM & IH

OBJECTIVE: To monitor the efficacy of anti-malarial treatments in Thailand. METHOD: A 28-day in vivo study in nine provinces along international borders in 2003. The first group comprised 164 patients from four provinces: Mae Hong Son, Chiang Mai, Ratchaburi and Ubon Ratchathani. These patients received 15 mg/kg mefloquine as a single dose. The second group, 58 patients from Kanchanaburi, were treated with 15 mg/kg mefloquine plus artesunate (12 mg/kg).

Author(s): 
Vijaykadga, Saowanit
Rojanawatsirivej, Chaiporn
Cholpol, Sawat
Phoungmanee, Duangduen
Nakavej, Argat
Wongsrichanalai, Chansuda
Publication Title: 
Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

BACKGROUND: Our study examined the relative contributions of host, pharmacokinetic, and parasitological factors in determining the therapeutic response to artemether-lumefantrine (AL). METHODS: On the northwest border of Thailand, patients with uncomplicated Plasmodium falciparum malaria were enrolled in prospective studies of AL treatment (4- or 6-dose regimens) and followed up for 42 days.

Author(s): 
Price, Ric N.
Uhlemann, Anne-Catrin
van Vugt, Michèle
Brockman, Al
Hutagalung, Robert
Nair, Shalini
Nash, Denae
Singhasivanon, Pratap
Anderson, Tim J. C.
Krishna, Sanjeev
White, Nicholas J.
Nosten, François
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

Patient data from eight clinical trials were pooled and analyzed to study the efficacy and safety of the six-dose versus four-dose regimen of artemether-lumefantrine (coartemether; Coartem) in children weighing 5-25 kg. A total of 544 patients with uncomplicated P. falciparum malaria (six-dose: 343; four-dose: 201), matched for demographic and baseline characteristics and individual coartemether doses were included in the analysis.

Author(s): 
Makanga, Michael
Premji, Zul
Falade, Catherine
Karbwang, Juntra
Mueller, Edgar A.
Andriano, Kim
Hunt, Philip
de Palacios, Patricia Ibarra
Publication Title: 
Tropical medicine & international health: TM & IH

OBJECTIVE: We assessed the feasibility and acceptability of and the willingness to use artemether-lumefantrine (Coartem) during early, appropriate treatment of malaria/fever in children aged 6-59 months at the community and household level in a rural malaria-endemic area in Ghana. METHOD: In this descriptive study with a pre- post-evaluation of an intervention, community perceptions of fever, health-seeking behaviour and current treatment practices for children aged 6-59 months were ascertained through qualitative research and surveys.

Author(s): 
Chinbuah, Amanua M.
Gyapong, John O.
Pagnoni, Franco
Wellington, Edith K.
Gyapong, Margaret
Publication Title: 
Malaria Journal

BACKGROUND: A six-dose antimalarial regimen of artemether-lumefantrine (A/L) may soon become one of the most widely used drug combination in Africa, despite possible constraints with adherence and poor absorption due to inadequate nutrition, and a lack of pharmacokinetic and effectiveness data. METHODS: Within a trial of supervised versus unsupervised A/L treatment in a stable Ugandan Plasmodium falciparum transmission setting, plasma lumefantrine concentrations were measured in a subset of patients on day 3 (C [lum]day3) and day 7 (C [lum]day7) post-inclusion.

Author(s): 
Checchi, Francesco
Piola, Patrice
Fogg, Carole
Bajunirwe, Francis
Biraro, Samuel
Grandesso, Francesco
Ruzagira, Eugene
Babigumira, Joseph
Kigozi, Isaac
Kiguli, James
Kyomuhendo, Juliet
Ferradini, Laurent
Taylor, Walter R. J.
Guthmann, Jean-Paul
Publication Title: 
Tropical medicine & international health: TM & IH

Artesunate and mefloquine combination treatment has been used since 2000 in Cambodia as the first-line drug for the treatment of uncomplicated falciparum malaria. In order to assess its efficacy and safety, the national malaria control programme conducted 14 therapeutic efficacy studies with the drug combination between 2001 and 2004 at nine sites. In 2001 and 2002, co-blister packs of artesunate and mefloquine were used, whereas in 2003 and 2004, drugs were given individually from a bulk pack at a total dose of 12 mg/kg of artesunate and 25 mg/kg of mefloquine over 3 days.

Author(s): 
Denis, Mey Bouth
Tsuyuoka, Reiko
Poravuth, Yi
Narann, Top Sophoan
Seila, Suon
Lim, Chim
Incardona, Sandra
Lim, Pharath
Sem, Rithy
Socheat, Duong
Christophel, Eva Maria
Ringwald, Pascal
Publication Title: 
Annals of Clinical Microbiology and Antimicrobials

BACKGROUND: Artemisinin-based combination therapy is increasingly being adopted as first-line antimalarial therapy. The choice of appropriate therapy depends on efficacy, cost, side effects, and simplicity of administration.

Author(s): 
Adam, Ishag
Magzoub, Mamoun
Osman, Maha E.
Khalil, Insaf F.
Alifrangis, Michael
Elmardi, Khalid A.
Publication Title: 
Tropical medicine & international health: TM & IH

BACKGROUND: Adherence to antimalarial drug regimens is improved by simple dosing. If the fixed antimalarial drug combination artemether-lumefantrine (AL) could be given once daily, this should improve adherence and thus effectiveness and lower the risk of selecting for resistance. METHODS: In an open randomized study, 43 patients with uncomplicated falciparum malaria were given equivalent doses of AL with 200 ml flavoured milk either as the conventional twice-daily regimen or as a single daily dose for 3 days.

Author(s): 
Ashley, Elizabeth A.
Stepniewska, Kasia
Lindegardh, Niklas
McGready, Rose
Annerberg, Anna
Hutagalung, Robert
Singtoroj, Thida
Hla, Gilvary
Brockman, Al
Proux, Stephane
Wilahphaingern, Jahser
Singhasivanon, Pratap
White, Nicholas J.
Nosten, François

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