Table 2 Recent Artemisinin Combination Treatment (ACT) Studies in small children
From: Use of mefloquine in children - a review of dosage, pharmacokinetics and tolerability data
Total No. of children | Age years/weight kg | No. of children treated with mefloquine | Important findings | |
|---|---|---|---|---|
Faye B et al. [11] A randomized trial of artesunate mefloquine versus artemether lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Senegalese children. Am J Trop Med Hyg 82(1), 140-144, 2010 | 320 | 4-5 y (10-20 kg) | 160 | The mefloquine (25 mg/kg) combination was effective > 96% and well tolerated. Even in very low weight children, vomiting in mefloquine arm was less than in comparator: 30% versus 36% |
Sowunmi A et al. [12] Therapeutic efficacy and effects of artesunate-mefloquine and mefloquine alone on malaria-associated anemia in children with uncomplicated Plasmodium falciparum malaria in southwest Nigeria. Am J Trop Med Hyg 81(6), 979-986, 2009 | 342 | <10 y (7-46 kg) | 342 | Fever and parasite clearance were faster with artesunate-mefloquine (25 mg/kg) than with mefloquine (25 mg/kg) alone. Resolution of anemia was similar in both groups. Both regimens were effective and well tolerated. |
Tietche F et al. [13] Tolerability and efficacy of a pediatric granule formulation of artesunate-mefloquine in young children from Cameroon with uncomplicated falciparum malaria. Am J Trop Med Hyg 82(6), 1034-1040, 2010 | 213 | Mean age 3 y (10-20 kg) | 213 | The combination was well tolerated and highly efficacious |
Mayxay M et al, [14] A phase III, randomized, non-inferiority trial to assess the efficacy and safety of dihydroartemisin-piperaquine versus artesunate-mefloquine in patients with uncomplicated Plasmodium falciparum malaria in Southern Laos. Am J Trop Med Hyg, 83(6)1221-1229, 2010 | 205 | < 15 y | 69 | Both regimens were effective, more adverse events were recorded for the AM group |
Frey SG et al. [15] Artesunate-mefloquine combination therapy in acute Plasmodium falciparum malaria in young children: a field study regarding neurological and neuropsychiatric safety. Malaria J,9:291, 2010 | 220 | 10-20 kg | 220 | Mefloquine (125 mg/day) for 3 days (in combination with artesunate (50 mg/day) was well tolerated by small children with a low incidence of neurological and neuropsychiatric adverse events, mainly sleeping disorder. All events resolved spontaneously. |
Ramharter M et al. [16] Pharmacokinetics of two paediatric artesunate-mefloquine drug formulations in the treatment of uncomplicated falciparum malaria in Gabon. J Antimicrob Chemother 60, 1091-1096, 2007 | 24 | 2-12 y and 11-37 kg | 24 | Exploratory analysis of mefloquine plasma levels showed a trend towards higher concentrations in younger age groups. All children, regardless of formulation used, achieved therapeutic and post treatment prophylactic protective levels of mefloquine |