A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brasil

Resumo

This clinical trial compared parasitological efficacy, levels of in vivo resistance and side effects of oral chloroquine 25 mg/Kg and 50 mg/Kg in 3 days treatment in Plasmodium falciparum malaria with an extended followed-up of 30 days. The study enroled 58 patients in the 25 mg/Kg group and 66 in the 50 mg/Kg group. All eligible subjects were over 14 years of age and came from Amazon Basin and Central Brazil during the period of August 1989 to April 1991. The cure rate in the 50 mg/Kg group was 89.4% on day 7 and 712% on day 14 compared to 44.8% and 24.1% in the 25 mg/Kg group. 74.1% of the patients in the 25 mg/Kg group and 48.4% of the patients in the 50 mg/Kg group had detectable parasitaemia at the day 30. However, there was a decrease of the geometric mean parasite density in both groups specially in the 50 mg/Kg group. There was 24.1% of R111 and 13.8% of RU in the 25 mg/Kg group. Side effects were found to be minimum in both groups. The present data support that there was a high level resistance to chloroquine in both groups, and the high dose regimen only delayed the development of resistance and its administration should not be recom-mended as first choice in malaria P. falciparum therapy in Brazil.

Descrição

Palavras-chave

Clinical trial, Malaria, Plasmodium falciparum, Chloroquine

Citação

ANDRADE, João Guimarães de et. al. A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brasil. Revista do Instituto de Medicina Tropical de São Paulo, São Paulo, v. 34, n. 5, p. 467-473, 1992.