以阿莫地喹为基础的联合治疗在无并发症恶性疟疾患儿中比以氯喹为基础的治疗更有效

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摘要

问题氯喹+磺胺多辛+乙胺、阿莫地喹+磺胺多辛+乙胺和阿莫地奎因+青蒿琥酯对非洲无并发症恶性疟疾儿童的相对有效性是多少?研究设计三组随机对照试验主要结果在第28天,与氯喹+磺胺多辛+乙胺嘧啶相比,布洛芬+磺胺多辛+乙胺嘧啶和阿莫地喹+青蒿琥酯显著降低了治疗失败的风险和抢救治疗的需要(p<0.0001;见结果表)。阿莫地喹+青蒿琥酯在28天时与阿莫地昆+磺胺多辛+乙胺相比显著降低了治疗失败,但在抢救治疗的必要性方面没有显著差异(见结果表)。作者的结论:在患有无并发症恶性疟疾的儿童中,以阿莫地喹为基础的联合治疗应被视为氯喹+磺胺多辛+乙胺嘧啶的替代方案。
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Amodiaquine based combination therapy is more effective than chloroquine-based therapy in children with uncomplicated falciparum malaria

Question

What is the relative effectiveness of chloroquine+sulfadoxine+pyrimethamine, amodiaquine+sulfadoxine+pyrimethamine, and amodiaquine+artesunate in children with uncomplicated falciparum malaria in Africa?

Study design

Three-arm randomised controlled trial

Main results

Amodiaquine+sulfadoxine+pyrimethamine and amodiaquine+artesunate significantly reduced the risk of treatment failure and the need for rescue therapy compared with chloroquine+sulfadoxine+pyrimethamine at 28 days (p<0.0001; see results table). Amodiaquine+artesunate significantly reduced treatment failure compared with amodiaquine+sulfadoxine+pyrimethamine at 28 days, but there was no significant difference in the need for rescue therapy (see results table).

Authors’ conclusions

Amodiaquine based combination therapies should be considered as an alternative to chloroquine+sulfadoxine+pyrimethamine in children with uncomplicated falciparum malaria.

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