This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pukrittayakamee, S.
Right arrow Articles by White, N. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pukrittayakamee, S.
Right arrow Articles by White, N. J.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, April 2004, p. 1329-1334, Vol. 48, No. 4
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.4.1329-1334.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Activities of Artesunate and Primaquine against Asexual- and Sexual-Stage Parasites in Falciparum Malaria

Sasithon Pukrittayakamee,1 Kesinee Chotivanich,1 Arun Chantra,1 Ralf Clemens,1 Sornchai Looareesuwan,1 and Nicholas J. White1,2*

Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand,1 Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom2

Received 15 September 2003/ Returned for modification 5 November 2003/ Accepted 9 December 2003

The activities of primaquine in combination with quinine or artesunate against asexual- and sexual-stage parasites were assessed in 176 adult Thai patients with uncomplicated Plasmodium falciparum malaria. Patients were randomized to one of the six following 7-day oral treatment regimens: (i) quinine alone, (ii) quinine with tetracycline, (iii) quinine with primaquine at 15 mg/day, (iv) quinine with primaquine at 30 mg/day, (v) artesunate alone, or (vi) artesunate with primaquine. Clinical recovery occurred in all patients. There were no significant differences in fever clearance times, rates of P. falciparum reappearance, or recurrent vivax malaria between the six treatment groups. Patients treated with artesunate alone or in combination with primaquine had significantly shorter parasite clearance times (mean ± standard deviation = 65 ± 18 versus 79 ± 21 h) and lower gametocyte carriage rates (40 versus 62.7%) than those treated with quinine (P <= 0.007). Primaquine did not affect the therapeutic response (P > 0.2). Gametocytemia was detected in 98 patients (56% [22% before treatment and 34% after treatment]). Artesunate reduced the appearance of gametocytemia (relative risk [95% confidence interval] = 0.34 [0.17 to 0.70]), whereas combinations containing primaquine resulted in shorter gametocyte clearance times (medians of 66 versus 271 h for quinine groups and 73 versus 137 h for artesunate groups; P <= 0.038). These results suggest that artesunate predominantly inhibits gametocyte development whereas primaquine accelerates gametocyte clearance in P. falciparum malaria.

* Corresponding author. Mailing address: Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand. Phone: 66-2-354-9172. Fax: 66-2-354-9169. E-mail: nickw{at}tropmedres.ac.

Antimicrobial Agents and Chemotherapy, April 2004, p. 1329-1334, Vol. 48, No. 4
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.4.1329-1334.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Pukrittayakamee, S., Imwong, M., Singhasivanon, P., Stepniewska, K., Day, N. J., White, N. J. (2008). Effects of Different Antimalarial Drugs on Gametocyte Carriage in P. Vivax Malaria. Am J Trop Med Hyg 79: 378-384 [Abstract] [Full Text]  
  • Griffith, K. S., Lewis, L. S., Mali, S., Parise, M. E. (2007). Treatment of Malaria in the United States: A Systematic Review. JAMA 297: 2264-2277 [Abstract] [Full Text]  
  • Sowunmi, A., Balogun, T., Gbotosho, G. O., Happi, C. T., Adedeji, A. A., Fehintola, F. A. (2007). Activities of Amodiaquine, Artesunate, and Artesunate-Amodiaquine against Asexual- and Sexual-Stage Parasites in Falciparum Malaria in Children. Antimicrob. Agents Chemother. 51: 1694-1699 [Abstract] [Full Text]  
  • Benoit-Vical, F., Lelievre, J., Berry, A., Deymier, C., Dechy-Cabaret, O., Cazelles, J., Loup, C., Robert, A., Magnaval, J.-F., Meunier, B. (2007). Trioxaquines Are New Antimalarial Agents Active on All Erythrocytic Forms, Including Gametocytes. Antimicrob. Agents Chemother. 51: 1463-1472 [Abstract] [Full Text]  
  • Chotivanich, K., Sattabongkot, J., Udomsangpetch, R., Looareesuwan, S., Day, N. P. J., Coleman, R. E., White, N. J. (2006). Transmission-blocking activities of quinine, primaquine, and artesunate.. Antimicrob. Agents Chemother. 50: 1927-1930 [Abstract] [Full Text]  
  • PIYAPHANEE, W., KRUDSOOD, S., TANGPUKDEE, N., THANACHARTWET, W., SILACHAMROON, U., PHOPHAK, N., DUANGDEE, C., HAOHARN, O., FAITHONG, S., WILAIRATANA, P., LEOWATTANA, W., LOOAREESUWAN, S. (2006). Emergence and clearance of gametocytes in uncomplicated Plasmodium falciparum malaria.. Am J Trop Med Hyg 74: 432-435 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»