BMJ 1994;308:286-287 (29 January)

Editorials

Mefloquine

Mefloquine is a quinoline-methanol compound structurally related to quinine.1 It is active against all the human malaria parasites, particularly multidrug resistant Plasmodium falciparum. Introduced a decade ago to treat falciparum malaria in Thailand, where multidrug resistance is a particular problem, it was formulated initially in a fixed combination with pyrimethamine-sulfadoxine to delay the onset of resistance. Unfortunately, that did not work, probably because of pharmacokinetic differences between the compounds and because P falciparum was already highly resistant to sulfadoxine and pyrimethamine when the combination was introduced.

By 1990, after five years of well controlled use, significant resistance to mefloquine was evident on the eastern and western borders of Thailand.2 This has increased steadily in these regions, and, although cure rates have improved since the treatment dose of mefloquine was raised from 15 mg base/kg to 25 mg/kg,3 high grade resistance (that is, failure to clear parasitaemia) now occurs in about . . . [Full text of this article]


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This article has been cited by other articles:

  • Thapa, R., Biswas, B. (2009). Childhood Mefloquine-Induced Mania and Psychosis: A Case Report. J Child Neurol 24: 1008-1009 [Abstract]  
  • Cravo, P. V. L., Carlton, J. M.-R., Hunt, P., Bisoni, L., Padua, R. A., Walliker, D. (2003). Genetics of Mefloquine Resistance in the Rodent Malaria Parasite Plasmodium chabaudi. Antimicrob. Agents Chemother. 47: 709-718 [Abstract] [Full text]  
  • Wooltorton, E. (2002). Mefloquine: contraindicated in patients with mood, psychotic or seizure disorders. CMAJ 167: 1147-1147 [Full text]  
  • Croft, A. (1995). Toxicity of mefloquine is similar to that of other chemoprophylaxis. BMJ 311: 191b-191 [Full text]  
  • Bradley, D J, Merritt, J C (1994). Antimalarial prophylaxis Manufacturers recommend more stringent guidelines for halofantrine. BMJ 308: 721-721 [Full text]  
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