Efikasi Monoterapi Artesunate Dibandingkan dengan Gabungan Kinin -Azithromycin pada Pengobatan Malaria Falsiparum tanpa Komplikasi pada Anak

Abstract

Background. Health Department of Indonesia Republic had changed the standard treatment of falciparum malaria into artesunate-amodiaquine combination since end of 2004. This was caused by previous malaria drugs have been resistant. We need to find alternative drug if this combination drug is not available.

Objective. To compare the efficacy of artesunate monotherapy with quinine- azithromycin combination, as the treatment for uncomplicated falciparum

malaria in children. Methods. This randomized open label clinical trial was conducted on July to August 2007 at Mandailing Natal, Sumatera Utara Province, in 5 to 18 years old children with positive P. falciparum from the peripheral blood smear. Group I received artesunate monotherapy orally and group II received quinine combined with azithromycin orally. Parasitemia was counted on day 0, 2, 7 and 28. Results. The cure rate was 100% and no recrudescence for both group on day 2, 7 and 28 (P=0,001). Headache, vomiting and tinnitus adverse event was found in 14, 7 and 4 children in group II (P=0,0001; 0,027; 0,039 ) respectively. Conclusion. Both of drugs can be used as alternative treatment for

uncomplicated falciparum malaria in children, but combination of quinine- azithromycin have more serious adverse reactions than artesunate

monotherapy