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Eficacia y tolerancia de la profilaxis de la malaria a largo plazo con mefloquina. Necesidad de un mejor régimen de
H O Lobel1, K W Bernard, S L Williams
1Division of Parasitic Diseases, Centers for Disease Control, Atlanta, Ga 30333.
JAMA
|January 16, 1991
Resumen
La profilaxis de la mefloquina para la malaria mostró una mayor eficacia en comparación con la cloroquina. Sin embargo, el régimen de cada dos semanas tenía niveles sanguíneos más bajos, lo que sugiere que la dosificación semanal puede ser mejor para prevenir las infecciones por Plasmodium falciparum.
Área de la Ciencia:
- La medicina tropical es una de ellas.
- Farmacología Farmacología.
- Enfermedades infecciosas Las enfermedades infecciosas.
Sus antecedentes:
- La malaria sigue siendo una amenaza significativa para la salud mundial, en particular el Plasmodium falciparum.
- La resistencia a la cloroquina requiere estrategias profilácticas alternativas.
- La mefloquina es una alternativa potencial para la profilaxis de la malaria.
Objetivo del estudio:
- Para comparar la eficacia y seguridad de la mefloquina frente a la cloroquina para la profilaxis de la malaria a largo plazo.
- Evaluar el impacto de las diferentes frecuencias de dosificación en la eficacia de la mefloquina.
- Para evaluar las reacciones adversas asociadas con la mefloquina profilaxis.
Principales métodos:
- Un estudio comparativo que involucró a voluntarios del Cuerpo de Paz en África Occidental.
- Los voluntarios recibieron mefloquina cada dos semanas o fosfato de cloroquina una vez por semana.
- Se registró la incidencia de la malaria por Plasmodium falciparum y los eventos adversos.
Principales resultados:
- La mefloquina demostró una eficacia 63% mayor que la cloroquina en la prevención de la malaria.
- La incidencia mensual de infecciones por P. falciparum fue de 1 por 100 voluntarios en tratamiento con mefloquina frente a 2,7 por 100 en tratamiento con cloroquina.
- Los fracasos de la profilaxis con mefloquina ocurrieron en la segunda semana del régimen de cada dos semanas, vinculados a concentraciones sanguíneas más bajas.
Conclusiones:
- Se debe considerar la profilaxis semanal de mefloquina (250 mg) para los viajeros a zonas de malaria resistentes a la cloroquina.
- El régimen de mefloquina cada dos semanas puede ser subóptimo debido a la disminución de los niveles sanguíneos.
- La mefloquina fue bien tolerada y no se observaron reacciones adversas graves.
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