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Randomized Controlled Trial
. 2008 May;78(5):736-40.

High-dose primaquine regimens against relapse of Plasmodium vivax malaria

Srivicha Krudsood  1 , Noppadon Tangpukdee, Polrat Wilairatana, Nantaporn Phophak, J Kevin Baird, Gary M Brittenham, Sornchai Looareesuwan
Affiliations
Randomized Controlled Trial

High-dose primaquine regimens against relapse of Plasmodium vivax malaria

Srivicha Krudsood et al. Am J Trop Med Hyg. 2008 May.

Abstract

Plasmodium vivax causes debilitating but usually non-lethal malaria in most of Asia and South America. Prevention of relapse after otherwise effective therapy for the acute attack requires a standard daily dose of primaquine administered over 14 days. This regimen has < 90% efficacy in Thailand, and is widely regarded as ineffective because of poor compliance over the relatively long duration of dosing. We evaluated the efficacy, safety, and tolerability of alternative primaquine dosing regimens combined with artesunate among 399 Thai patients with acute, symptomatic P. vivax malaria. Patients were randomly assigned to one of six treatment groups: all patients received artesunate, 100 mg once a day for 5 days. Groups 1-5 then received primaquine, 30 mg a day for 5, 7, 9, 11, and 14 days, respectively. Group 6 received primaquine, 30 mg twice a day for 7 days. The 28-day cure rates were 85%, 89%, 94%, 100%, and 96%, respectively. Treatment of P. vivax malaria with artesunate for 5 days followed by high-dose primaquine, 30 mg twice a day for 7 days, was highly effective, well-tolerated, and equivalent or superior to the standard regimen of primaquine therapy.

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Conflict of interest statement

Disclosure: The authors have no conflict of interest with respect to this study.

Figures

Figure 1
Figure 1
Mean hematocrit level of patients receiving high-dose primaquine.
See this image and copyright information in PMC

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