Population pharmacokinetics and pharmacodynamics of the artesunate–mefloquine fixed dose combination for the treatment of uncomplicated falciparum malaria in African children

by Guidi M, Mercier T, Aouri M, Decosterd LA, Csajka C, Ogutu B, Carn G, Kiechel JR. Malaria Journal 2019, 18:139, doi:10.1186/s12936-019-2754-6.

Summary: WHO has recommended reconsideration of the use of ASMQ in Africa, where it is not frequently used due to perceived poor tolerance of mefloquine. In a large clinical study, the pharmacokinetics of a fixed dose combination of ASMQ was investigated in an African paediatric population. A subset of 50 Kenyan children from this trial underwent intensive sampling to develop population pharmacokinetic models for AS, its metabolite dihydroartemisinin (DHA) and MQ. Body weight was shown to be the largest contributor to variability in drug exposure. This is accommodated for by the ASMQ fixed dose combination dosing recommendation; beyond this there is no indication that the dosage should be modified in children with malaria compared to adults.

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