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Cloroquina o amodiaquina combinadas con sulfadoxina‐pirimetamina para tratar la malaria no complicada: una revisión sistemática
Author(s) -
Hwang Jimee,
Bitarakwate Edward,
Pai Madhukar,
Reingold Arthur,
Rosenthal Philip J.,
Dorsey Grant
Publication year - 2006
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2006.01571.x
Subject(s) - amodiaquine , medicine , sulfadoxine/pyrimethamine , sulfadoxine , malaria , relative risk , meta analysis , adverse effect , chloroquine , randomized controlled trial , pyrimethamine , traditional medicine , confidence interval , immunology
Summary Objective To compare the efficacies against uncomplicated falciparum malaria of chloroquine (CQ), amodiaquine (AQ), sulfadoxine–pyrimethamine (SP) and combinations of these inexpensive drugs. Methods We searched Medline, Embase, Cochrane CENTRAL Register of Controlled Trials, BIOSIS, Web of Science, African Index Medicus, DARE, Digital Dissertations and Current Controlled Trials for randomised or quasi‐randomised controlled trials conducted between 1991 and June 2004 regardless of language and geography. We also contacted malaria experts, searched reference lists, and contacted individual authors for unreported study characteristics and additional data. Unpublished data were sought and included in the analyses. Results Thirteen randomised trials ( n = 4248) were identified and the summary relative risks of treatment failure at 28 days were calculated. There was marginal benefit in adding CQ to SP, compared with SP monotherapy (RR = 0.74, 95% CI 0.54–1.02). Combining AQ with SP was associated with a significantly lower risk of treatment failure than SP monotherapy (RR = 0.35, 95% CI 0.15–0.82) and AQ monotherapy (RR = 0.59, 95% CI 0.42–0.83). AQ plus SP was associated with a significantly lower risk of treatment failure than CQ plus SP (RR = 0.42, 95% CI 0.25–0.72). Serious adverse events were rare and did not increase with combination therapy. Conclusion Amodiaquine plus SP remains an efficacious, affordable and safe option for treating malaria in certain settings.