| published 13-10-2005
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A 5-day course of oral artesunate monotherapy (first day: 4 mg/kg body weight, observed intake; and 2 mg/kg body weight on the following days with nonobserved drug intake) yielded a PCR-corrected Day 28 cure rate of 90% (45 of 50 patients; CI 78–97%) in Gabonese children aged 2 to 18 months. Am. J. Trop. Med. Hyg., 73(4), 2005, pp. 705-709.
Full Title: 5-Day Nonobserved Artesunate Monotherapy For Treating Uncomplicated Falciparum Malaria In Young Gabonese Children.
We regularly use Fansidar (sulfadoxine-pyrimethamine, SP) with
artesunate rather than using artesunate monotherapy, because of
concerns of relapse. This study shows 90% cure rate with monotherapy.
However, because of the small sample size, the confidence interval for
the cure rate is 78-97%. I'd probably be willing to use monotherapy if
I was confident of a 90% cure rate, but not if it is only 78%. So in
the absence of a larger study, I for one will continue to use a second
drug along with artesunate in the children I treat.
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