Prospective comparison of methods for the early prediction of treatment failure in patients with falciparum malaria.

The prompt identification of patients with falciparum malaria who are at risk of late therapeutic failure could help clinicians avoid the dangers of missed or delayed retreatment. Different methods for predicting late recrudescence were compared for 52 patients whose parasitemia initially cleared after treatment with either halofantrine or quinine. Parasites reappeared in the peripheral circulation of six individuals 17 to 28 days after the initiation of therapy.

Pharmacokinetics of an extended-dose halofantrine regimen in patients with malaria and in healthy volunteers.

The pharmacokinetics and tolerance of a 4.5 gm 7-day halofantrine loading dose regimen were evaluated in 10 Thai patients with malaria and in 10 noninfected volunteers. Halofantrine peak plasma concentrations and bioavailability on the first day of treatment were significantly lower in patients with malaria than in healthy volunteers.

Efficacy and tolerance of extended-dose halofantrine for drug-resistant falciparum malaria in Thailand.

New treatments for malaria are urgently needed in areas such as Thailand where highly drug-resistant strains of Plasmodium falciparum are prevalent. Mefloquine is rapidly losing efficacy and conventional doses of halofantrine are infective. We therefore used pharmacokinetic stimulation to design an extended-dose halofantrine regimen and tested it in 26 soldiers stationed along the Thai-Cambodian border.