Efikasi Gabungan Kinin-Azitromisin dan Artesunat-Amodiakuin pada Pengobatan Malaria Falsiparum tanpa Komplikasi pada Anak

Abstract

Background. Resistance of malaria treatment is a major problem in treating malaria patient. Because of the highly incidence of malaria falciparum resistance still found in lndonesia, Department of Health, Republic of Indonesia since end of 2004 changed the standard treatment into artesunate-amodiaquine combination.

objective. To compare the efficacy of artesunate-amodiaquine and quinine- azithromycin combination as treatment for uncomplicated malaria falciparum

in children. Methods. we conducted a randomized, open label, clinical trial since August 2006 until September 2006 in Panyabungan, Kabupaten Mandailing Natal, North sumatera Province, among school age children between 5 to 16 years. Group I received artesunate 4 mg/bw/po combined with amodiaquine 10 mg/bw for 3 days, Group ll received oral quinine for 7 days, 10 mg/kw/divided in 3.d.oses for 4 days continued with 5 mg/bw/divided in 3 doses for 3 days combined with azithromycin 10 mg/bw/po for 3 days. Evaluation done only for parasitologic cure rate but not for clinical outcome. Parasitologic cure rate was evaluated by counting parasitemia at day 0, 2,7 , and 28. Results. Peripheral blood smear was done, and 232 were positive for falciparum malaria, Participants, randomly separated into two groups, 116 received artesunate-amodiaquine and 116 received quinine-azitliromycin. of each 116, 114 and 106 children completed study in group I and ll, respectively. From peripheral blood smear at day 2,7 and 28 we found 100% cure rate for both group (P = 0,001). Tinnitus adverse event was found in 6 children in group ll (P = 0,042). Conclusion. Quinine-azithromycin combination can give good outcome and use as treatment for uncomplicated falciparum malaria in children. No significant differences of parasitologic cure rate and side effect statistically compared to artesunate-amodiaquine combination.