section name header

Evidence summaries

Artesunate Plus Mefloquine Versus Mefloquine for Treating Uncomplicated Malaria

Artesunate (10 mg) plus mefloquine (25 mg/kg) performs better than mefloquine alone for treating uncomplicated falciparum malaria in areas with low malaria transmission. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 8 studies with a total of 1 996 subjects. All were conducted in areas with low malaria transmission, seven in South-East Asia and one in the Peruvian Amazon. The doses and dosing regimens of artesunate and mefloquine varied across trials. The trials using a total dose of 25 mg/kg mefloquine and 10 mg artesunate reported fewer treatment failures with the combination at all time points: day 28 (RR 0.17, 95% CI 0.06 to 0.47; 824 participants, 4 trials), day 42 (RR 0.23, 95% CI 0.14 to 0.39; 298 participants, 1 trial), and day 63 (RR 0.26, 95% CI 0.09 to 0.77; 501 participants, 2 trials). The results for parasitaemia showed a similar trend. Trials using a lower dose of artesunate tended to favour the artesunate plus mefloquine combination. Overall, adverse events were similar across treatment arms.

    References

    • Bukirwa H, Orton L. Artesunate plus mefloquine versus mefloquine for treating uncomplicated malaria. Cochrane Database Syst Rev 2005 Oct 19;(4):CD004531. [PubMed]

Primary/Secondary Keywords