Malaria treatment failures after artemisinin-based therapy in three expatriates: could improved manufacturer information help to decrease the risk of treatment failure?

Artemisinin-containing therapies are highly effective against Plasmodium falciparum malaria. Insufficient numbers of tablets and inadequate package inserts result in sub-optimal dosing and possible treatment failure. This study reports the case of three, non-immune, expatriate workers with P. falciparum acquired in Africa, who failed to respond to artemisinin-based therapy. Sub-therapeutic dosing in accordance with the manufacturers' recommendations was the probable cause.
Manufacturers information and drug content included in twenty-five artemisinin-containing specialities were reviewed.
A substantial number of manufacturers do not follow current WHO recommendations regarding treatment duration and doses.
This study shows that drug packaging and their inserts should be improved.
AuthorsYves Jackson, François Chappuis, Louis Loutan, Walter Taylor
JournalMalaria journal (Malar J) Vol. 5 Pg. 81 ( 2006) ISSN: 1475-2875 [Electronic] England
PMID17020598 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antimalarials
  • Artemisinins
  • Ethanolamines
  • Fluorenes
  • Lactones
  • Sesquiterpenes
  • artesunate
  • artemether
  • lumefantrine
  • artemisin
  • Adult
  • Antimalarials (administration & dosage, therapeutic use)
  • Artemisinins (administration & dosage, therapeutic use)
  • Cote d'Ivoire
  • Dose-Response Relationship, Drug
  • Drug Labeling (standards)
  • Ethanolamines (administration & dosage, therapeutic use)
  • Female
  • Fluorenes (administration & dosage, therapeutic use)
  • Guidelines as Topic
  • Guinea
  • Humans
  • Lactones (administration & dosage, therapeutic use)
  • Malaria, Falciparum (drug therapy)
  • Parasitemia (drug therapy)
  • Recurrence
  • Risk
  • Sesquiterpenes (administration & dosage, therapeutic use)
  • Sudan
  • Switzerland (ethnology)
  • Treatment Failure
  • World Health Organization

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