%0 Journal Article
%T Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali
%A Mamadou M Tekete
%A S¨¦kou Toure
%A Alfia Fredericks
%A Abdoul H Beavogui
%A Cheick PO Sangare
%A Alicia Evans
%A Peter Smith
%A Hamma Maiga
%A Zoumana I Traore
%A Ogobara K Doumbo
%A Karen I Barnes
%A Abdoulaye A Djimde
%J Malaria Journal
%D 2011
%I BioMed Central
%R 10.1186/1475-2875-10-275
%X In a randomized controlled trial, children aged 6-59 months with uncomplicated falciparum malaria, received either one dose of sulphadoxine-pyrimethamine alone (SP), one dose of SP plus three daily doses of amodiaquine (SP+AQ) or one dose of SP plus 3 daily doses of artesunate (SP+AS). Exactly 100 ¦Ìl of capillary blood was collected onto filter paper before drug administration at day 0 and at days 1, 3, 7, 14, 21 and 28 after drug administration for analysis of sulphadoxine and pyrimethamine pharmacokinetic parameters.Fourty, 38 and 31 patients in the SP, SP+AQ and SP+AS arms, respectively were included in this study. The concentrations on day 7 (that are associated with therapeutic efficacy) were similar between the SP, SP+AQ and SP+AS treatment arms for sulphadoxine (median [IQR] 35.25 [27.38-41.70], 34.95 [28.60-40.85] and 33.40 [24.63-44.05] ¦Ìg/mL) and for pyrimethamine (56.75 [46.40-92.95], 58.75 [43.60-98.60] and 59.60 [42.45-86.63] ng/mL). There were statistically significant differences between the pyrimethamine volumes of distribution (4.65 [3.93-6.40], 4.00 [3.03-5.43] and 5.60 [4.40-7.20] L/kg; p = 0.001) and thus elimination half-life (3.26 [2.74 -3.82], 2.78 [2.24-3.65] and 4.02 [3.05-4.85] days; p < 0.001). This study confirmed the lower SP concentrations previously reported for young children when compared with adult malaria patients.Despite slight differences in pyrimethamine volumes of distribution and elimination half-life, these data show similar exposure to SP over the critical initial seven days of treatment and support the current use of SP in combination with either AQ or AS for uncomplicated falciparum malaria treatment in young Malian children.Malaria remains a major public health problem, particularly in sub-Saharan Africa, where it claims nearly 750,000 lives of children under the age of five years [1]. To improve cure rates and delay the development and spread of artemisinin resistance, the World Health Organization (WHO) recommends artem
%K Pharmacokinetic
%K Combination therapy
%K Sulphadoxine
%K Pyrimethamine
%K Amodiaquine
%K Artesunate and Malaria
%U http://www.malariajournal.com/content/10/1/275