Intervention Review

Amodiaquine for treating malaria

  1. Piero L Olliaro1,*,
  2. Paola Mussano2

Editorial Group: Cochrane Infectious Diseases Group

Published Online: 22 APR 2003

Assessed as up-to-date: 3 FEB 2003

DOI: 10.1002/14651858.CD000016

How to Cite

Olliaro PL, Mussano P. Amodiaquine for treating malaria. Cochrane Database of Systematic Reviews 2003, Issue 2. Art. No.: CD000016. DOI: 10.1002/14651858.CD000016.

Author Information

  1. 1

    World Health Organization, UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland

  2. 2

    Genthod, Switzerland

*Piero L Olliaro, UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, 1211 Geneva 27, Geneva, Switzerland. olliarop@who.int.

Publication History

  1. Publication Status: Stable (no update expected for reasons given in 'What's new')
  2. Published Online: 22 APR 2003

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Using a pilot system we have categorised this review as: Historical question - no update intended. Please see "Published notes" section of the review for more details.

Since 2001, the World Health Organization has recommended that antimalarial drug combinations be used for  uncomplicated falciparum malaria and that monotherapy should no longer be used. For the most up-to-date information on malaria combination treatment, please refer to Sinclair D, Zani B, Donegan S, Olliaro P, Garner P. Artemisinin-based combination therapy for treating uncomplicated malaria. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD007483. DOI: 10.1002/14651858.CD007483.pub2.

Amodiaquine has been widely used to treat malaria. Fatal adverse reactions have been reported in adults taking it for prophylaxis. This has led some authorities to suggest it is withdrawn as a first line treatment for malaria.

Objectives

To compare amodiaquine with chloroquine or sulfadoxine-pyrimethamine for treating uncomplicated Plasmodium falciparum malaria.

Search methods

We searched the Cochrane Infectious Diseases Group specialized trials register (February 2003), The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2003), MEDLINE (1966 to February 2003), EMBASE (1980 to December 2002), LILACS (February 2003). We contacted researchers in the field and pharmaceutical companies.

Selection criteria

Randomised and quasi-randomised trials.

Data collection and analysis

Two reviewers independently extracted data and assessed trial quality.

Main results

56 studies included, mostly from Africa. Treatment allocation was adequately concealed in three trials, and unclear or inadequate in the remainder. Amodiaquine was more effective than chloroquine for parasite clearance (day 7, Peto odds ratio 4.42 (95% confidence interval 3.65 to 5.35); day 14, Peto odds ratio 6.44 (95% confidence interval (CI) 5.09 to 8.15). Comparisons with sulfadoxine/pyrimethamine were more mixed, with sulfadoxine/pyrimethamine more effective on day 28 (Peto odds ratio 0.41; 95% CI 0.28 to 0.61). No significant difference for adverse events was observed between amodiaquine and chloroquine and sulfadoxine/pyrimethamine. Reported adverse effects were minor or moderate. No life threatening events were detected.

Authors' conclusions

There is evidence to support the continued use of amodiaquine to treat uncomplicated malaria, although local drug resistance patterns need to be considered. Monitoring for adverse events should continue.

This review summarizes trials up to 2003. For the reasons in the 'What's new' section, this review will no longer be updated.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Amodiaquine for treating malaria

Using a pilot system we have categorised this review as: Historical question - no update intended. Please see "Published notes" section of the review for more details.

Since 2001, the World Health Organization has recommended that antimalarial drug combinations be used for  uncomplicated falciparum malaria and that monotherapy should no longer be used.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

以Amodiaquine治療瘧疾

醫界已廣泛地使用Amodiaquine來治療瘧疾。已經有報告指出在成人中以此藥物作為預防瘧疾會產生致命的不良反應。因此某些當局建議不要將它拿來當作治療瘧疾的第一線藥物。

目標

比較以amodiaquine與 chloroquine或是sulfadoxinepyrimethamine治療非重症瘧原蟲型寄生蟲瘧疾。

搜尋策略

我們搜尋Cochrane Infectious Diseases Group specialized trials register (2003年2月)、 Cochrane Central Register of Controlled Trials (Cochrane Library Issue 1, 2003)、 MEDLINE (1966年−2003年2月)、 EMBASE (1980年−2002年12月)、 LILACS (2003年2月)。我們聯繫本領域的研究人員,以及藥廠。

選擇標準

隨機(Randomised)與半隨機試驗(quasirandomised trials)。

資料收集與分析

有2位審稿者獨立擷取出資料,並評估了試驗的品質。

主要結論

其中包含了56份研究,大多數是來自於非洲。在其中3項試驗當中,治療分配的方式有適當地隱藏,至於在其餘的試驗當中,治療分配的方式不清楚或是不恰當。對於清除寄生蟲的成效來說,Amodiaquine比 chloroquine要來得有效(第7天,Peto odds ratio 4.42(95%信賴區間為3.65到5.35);第14天,Peto odds ratio 6.44(95%信賴區間(CI)為5.09到8.15))。跟sulfadoxine/pyrimethamine比較起來的時候,情況就會更為複雜,因為sulfadoxine/pyrimethamine在第28天的時候較為有效(Peto odds ratio 0.41;95% CI 0.28 to 0.61)。對於不良反應來說,在amodiaquine與chloroquine以及sulfadoxine/pyrimethamine之間,並沒有發現任何顯著的差異。被報告的不良影響也都是輕至中度。其中並未偵測到任何會構成生命危險的狀況。a

作者結論

雖然說仍須考慮區域內的抗藥性,這些證據已經足夠支持我們持續使用amodiaquine來治療瘧疾。對於不良反應的監控須要持續進行。本篇回顧中所歸納的試驗都是在2003年之前所完成, 因此針對「更新項目」將不再進行。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

摘要準備中