RII and RIII type resistance of Plasmodium falciparum to combination of mefloquine and sulfadoxine/pyrimethamine in Indonesia

• Published in: The Lancet (British edition) Vol. 2; no. 8463; p. 1039
• Main Authors: Hoffman, S L, Rustama, D, Dimpudus, A J, Punjabi, N H, Campbell, J R, Oetomo, H S, Marwoto, H A, Harun, S, Sukri, N, Heizmann, P
• Format: Journal Article
• Language: English
• Published: England 09.11.1985
• Subjects: Adolescent; Adult; Antimalarials - administration & dosage; Antimalarials - pharmacology; Antimalarials - therapeutic use; Child; Clinical Trials as Topic; Drug Combinations - administration & dosage; Drug Combinations - pharmacology; Drug Resistance, Microbial; Drug Therapy, Combination; Female; Humans; Indonesia; Malaria - drug therapy; Malaria - parasitology; Male; Mefloquine; Plasmodium falciparum - drug effects; Pyrimethamine - administration & dosage; Pyrimethamine - pharmacology; Quinolines - pharmacology; Quinolines - therapeutic use; Random Allocation; Sulfadoxine - administration & dosage; Sulfadoxine - pharmacology; Sulfanilamides - therapeutic use; Indonesia
• ISSN: 0140-6736

2 of 36 Plasmodium falciparum infections were resistant (RII and RIII) in vivo to the combination of mefloquine (M) and sulfadoxine-pyrimethamine (SP) in Jayapura, Irian Jaya, Indonesia. Expected absorption of mefloquine and pyrimethamine was confirmed in the one resistant patient from whom sera were available, and the isolate from this patient was sensitive to mefloquine in vitro. Only 2 of 41 infections studied at the same time were resistant in vivo to SP. There was no clinical advantage of MSP compared with SP, and limited observations suggest there may be a disadvantage.