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Blood levels of sulfadoxine and pyrimethamine, according to the malaria-treatment response, in two municipalities of Antioquia, Colombia [Concentraciones sanguíneas de sulfadoxina y pirimetamina según la respuesta terapéutica antimalárica, en dos municipios de Antioquia, Colombia]

Carmona J.; Pabon A.; Marquez D.; Lopez C.; Morales G.; Blair S.
Fonte: Universidade de Medellín Publicador: Universidade de Medellín
Tipo: Article; info:eu-repo/semantics/article
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Problem. There has been a constant increase in the level of therapeutic failure of the sulfadoxine-pyrimethamine (SP) combination for treating uncomplicated Plasmodium falciparum malaria. Objective. To use high-performance liquid chromatography to quantify blood levels of SP in patients with good clinical response and in patients who did not respond to treatment. Methods. This experimental study was carried out in 2002 in Turbo and Zaragoza, two municipalities in the department of Antioquia in Colombia. There were 79 patients (45 in Turbo and 34 in Zaragoza), including both men and women, who ranged in age from 1 year to 60 years. All the patients had uncomplicated Plasmodium falciparum malaria, with a parasite density of 500 to 50 000 parasites/μL. The patients were each randomly assigned to a treatment group. The treatment groups were not blinded; the physician who provided the medication also evaluated the therapeutic response. The treatment consisted of a single combination dose of sulfadoxine (25 mg/kg) and pyrimethamine (1.25 mg/kg) in tablets (500 mg of sulfadoxine and 25 mg of pyrimethamine). Clinical- parasitological follow-up was carried out for 21 days. Blood levels of sulfadoxine and pyrimethamine were measured two hours after the treatment was given and also the day of treatment failure...