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In Vivo and In Vitro Efficacy of Amodiaquine Monotherapy for Treatment of Infection by Chloroquine-Resistant Plasmodium vivax

Hasugian, A. R., Tjitra, Emiliana, Ratcliff, A., Siswantoro, H., Kenangalem, Enny, Wuwung, R. M., Purba, H. L. E., Piera, K., Chalfein, Ferryanto, Marfurt, Jutta, Penttinen, P. M. P., Russell, Bruce, Anstey, Nicholas M. and Price, Ric N. (2009). In Vivo and In Vitro Efficacy of Amodiaquine Monotherapy for Treatment of Infection by Chloroquine-Resistant Plasmodium vivax. Antimicrobial Agents and Chemotherapy,53(3):1094-1099.

Document type: Journal Article
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IRMA ID 10026xPUB5
Title In Vivo and In Vitro Efficacy of Amodiaquine Monotherapy for Treatment of Infection by Chloroquine-Resistant Plasmodium vivax
Author Hasugian, A. R.
Tjitra, Emiliana
Ratcliff, A.
Siswantoro, H.
Kenangalem, Enny
Wuwung, R. M.
Purba, H. L. E.
Piera, K.
Chalfein, Ferryanto
Marfurt, Jutta
Penttinen, P. M. P.
Russell, Bruce
Anstey, Nicholas M.
Price, Ric N.
Journal Name Antimicrobial Agents and Chemotherapy
Publication Date 2009
Volume Number 53
Issue Number 3
ISSN 1098-6596   (check CDU catalogue  open catalogue search in new window)
Start Page 1094
End Page 1099
Total Pages 6
Place of Publication Washington, United States
Publisher American Society for Microbiology
HERDC Category C1 - Journal Article (DEST)
Abstract Amodiaquine retains efficacy against infection by chloroquine-resistant Plasmodium falciparum; however, little information is available on its efficacy against infection by chloroquine-resistant Plasmodium vivax. Patients presenting to a rural clinic with a pure P. vivax infection that recurred after recent antimalarial treatment were retreated, this time with amodiaquine monotherapy, and the risk of further recurrence within 4 weeks was assessed. Of the 87 patients with pure P. vivax infection, 15 patients did not complete a full course of treatment, 4 of whom were intolerant to treatment. In the 72 patients completing treatment, 91% (63 of 69) had cleared their parasitemia within 48 h with no early treatment failure. Follow-up to day 28 or recurrent parasitemia was achieved for 56 patients (78%). The cumulative incidence of treatment failure by day 28 was 22.8% (95% confidence interval, 7.3 to 38%). The in vitro sensitivity profile was determined for a separate set of isolates from outpatients with pure P. vivax infection. The median 50% inhibitory concentration of amodiaquine was 11.3 nM (range, 0.37 to 95.8) and was correlated significantly with that of chloroquine (Spearman rank correlation coefficient, 0.602; P < 0.001) Although amodiaquine results in a rapid clinical response, the risk of recurrence by day 28 is unacceptably high, reducing its suitability as an alternative treatment of infection by chloroquine-resistant P. vivax in this region.
Keywords in vivo efficiacy
in vitro efficacy
amodiaquine
monotherapy
treatment
infection
chloroquine-resistant
Plasmodium vivax
P. vivax
malaria
DOI http://dx.doi.org/10.1128/AAC.01511-08   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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