Malaria treatment failures after artemisinin-based therapy in three expatriates: could improved manufacturer...

Artemisinin-containing therapies are highly effective against Plasmodium falciparum malaria. Insufficient numbers of tablets and inadequate package inserts result in sub-optimal dosing and possible treatment failure. This study reports the case of three, non-immune, expatriate workers with P. falciparum acquired in Africa, who failed to respond to artemisinin-based therapy. Sub-therapeutic dosing in accordance with the manufacturers' recommendations was the probable cause.

Manufacturers information and drug content included in twenty-five artemisinin-containing specialities were reviewed.

A substantial number of manufacturers do not follow current WHO recommendations regarding treatment duration and doses.

This study shows that drug packaging and their inserts should be improved.