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Antimicrobial Agents and Chemotherapy, January 1998, p. 135-139, Vol. 42, No. 1
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Randomized Comparison of Artemether-Benflumetol and Artesunate-Mefloquine in Treatment of MultidrugResistant Falciparum Malaria

M. van Vugt,1,2,3 A. Brockman,1,3 B. Gemperli,4 C. Luxemburger,1,3 I. Gathmann,4 C. Royce,4 Thra Slight,1 S. Looareesuwan,3 N. J. White,1,3,5,* and F. Nosten1,3,5

Shoklo Malaria Research Unit, Mae Sod, Tak Province,1 and Faculty of Tropical Medicine, Mahidol University, Bangkok,3 Thailand; Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands2; Novartis, International Clinical Research, Basel, Switzerland4; and Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom5

Received 25 July 1997/Returned for modification 11 August 1997/Accepted 25 September 1997

An open, randomized comparison of artemether-benflumetol (CGP 56 697; Novartis) with artesunate-mefloquine was conducted in 617 patients with acute uncomplicated multidrug-resistant falciparum malaria on the western border of Thailand. Both treatments rapidly and reliably cleared fever and parasitemia, and there was no significant difference in the initial therapeutic response parameters. Parasite genotyping was used to distinguish recrudescences from new infections. The 63-day cure rate for artesunate-mefloquine (94%) was significantly higher than the cure rate for artemether-benflumetol (81%) (P < 0.001). Both regimens were well tolerated. Nausea, vomiting, dizziness, sleep disorders, and other neurological side effects were between two and four times more common in the artesunate-mefloquine group than in the artemether-benflumetol group (P < 0.001). Artemether-benflumetol is effective and very well tolerated in the treatment of multidrug-resistant falciparum malaria. A higher dose than that used in the present study may improve efficacy.

* Corresponding author. Mailing address: Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand. Phone: 662 246 0832. Fax: 662 246 7795. E-mail: tmnjw{at}mucc.mahidol.ac.th.

Antimicrobial Agents and Chemotherapy, January 1998, p. 135-139, Vol. 42, No. 1
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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