Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali

dc.contributor.authorTekete, Mamadouen_ZA
dc.contributor.authorToure, Sekouen_ZA
dc.contributor.authorFredericks, Alfiaen_ZA
dc.contributor.authorBeavogui, Abdoulen_ZA
dc.contributor.authorSangare, Cheicken_ZA
dc.contributor.authorEvans, Aliciaen_ZA
dc.contributor.authorSmith, Peteren_ZA
dc.contributor.authorMaiga, Hammaen_ZA
dc.contributor.authorTraore, Zoumanaen_ZA
dc.contributor.authorDoumbo, Ogobaraen_ZA
dc.contributor.authorBarnes, Karenen_ZA
dc.contributor.authorDjimde, Abdoulayeen_ZA
dc.date.accessioned2015-10-30T09:34:09Z
dc.date.available2015-10-30T09:34:09Z
dc.date.issued2011en_ZA
dc.description.abstractBACKGROUND:Sulphadoxine-pyrimethamine, in combination with artesunate or amodiaquine, is recommended for the treatment of uncomplicated malaria and is being evaluated for intermittent preventive treatment. Yet, limited data is available on pharmacokinetic interactions between these drugs. METHODS: In a randomized controlled trial, children aged 6-59 months with uncomplicated falciparum malaria, received either one dose of sulphadoxine-pyrimethamine alone (SP), one dose of SP plus three daily doses of amodiaquine (SP+AQ) or one dose of SP plus 3 daily doses of artesunate (SP+AS). Exactly 100 mul of capillary blood was collected onto filter paper before drug administration at day 0 and at days 1, 3, 7, 14, 21 and 28 after drug administration for analysis of sulphadoxine and pyrimethamine pharmacokinetic parameters. RESULTS: Fourty, 38 and 31 patients in the SP, SP+AQ and SP+AS arms, respectively were included in this study. The concentrations on day 7 (that are associated with therapeutic efficacy) were similar between the SP, SP+AQ and SP+AS treatment arms for sulphadoxine (median [IQR] 35.25 [27.38-41.70], 34.95 [28.60-40.85] and 33.40 [24.63-44.05] mug/mL) and for pyrimethamine (56.75 [46.40-92.95], 58.75 [43.60-98.60] and 59.60 [42.45-86.63] ng/mL). There were statistically significant differences between the pyrimethamine volumes of distribution (4.65 [3.93-6.40], 4.00 [3.03-5.43] and 5.60 [4.40-7.20] L/kg; p = 0.001) and thus elimination half-life (3.26 [2.74 -3.82], 2.78 [2.24-3.65] and 4.02 [3.05-4.85] days; p < 0.001). This study confirmed the lower SP concentrations previously reported for young children when compared with adult malaria patients. CONCLUSION: Despite slight differences in pyrimethamine volumes of distribution and elimination half-life, these data show similar exposure to SP over the critical initial seven days of treatment and support the current use of SP in combination with either AQ or AS for uncomplicated falciparum malaria treatment in young Malian children.en_ZA
dc.identifier.apacitationTekete, M., Toure, S., Fredericks, A., Beavogui, A., Sangare, C., Evans, A., ... Djimde, A. (2011). Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali. <i>Malaria Journal</i>, http://hdl.handle.net/11427/14527en_ZA
dc.identifier.chicagocitationTekete, Mamadou, Sekou Toure, Alfia Fredericks, Abdoul Beavogui, Cheick Sangare, Alicia Evans, Peter Smith, et al "Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali." <i>Malaria Journal</i> (2011) http://hdl.handle.net/11427/14527en_ZA
dc.identifier.citationTekete, M. M., Toure, S., Fredericks, A., Beavogui, A. H., Sangare, C. P., Evans, A., ... & Djimde, A. A. (2011). Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali. Malaria journal, 10(1), 1-8.en_ZA
dc.identifier.ris TY - Journal Article AU - Tekete, Mamadou AU - Toure, Sekou AU - Fredericks, Alfia AU - Beavogui, Abdoul AU - Sangare, Cheick AU - Evans, Alicia AU - Smith, Peter AU - Maiga, Hamma AU - Traore, Zoumana AU - Doumbo, Ogobara AU - Barnes, Karen AU - Djimde, Abdoulaye AB - BACKGROUND:Sulphadoxine-pyrimethamine, in combination with artesunate or amodiaquine, is recommended for the treatment of uncomplicated malaria and is being evaluated for intermittent preventive treatment. Yet, limited data is available on pharmacokinetic interactions between these drugs. METHODS: In a randomized controlled trial, children aged 6-59 months with uncomplicated falciparum malaria, received either one dose of sulphadoxine-pyrimethamine alone (SP), one dose of SP plus three daily doses of amodiaquine (SP+AQ) or one dose of SP plus 3 daily doses of artesunate (SP+AS). Exactly 100 mul of capillary blood was collected onto filter paper before drug administration at day 0 and at days 1, 3, 7, 14, 21 and 28 after drug administration for analysis of sulphadoxine and pyrimethamine pharmacokinetic parameters. RESULTS: Fourty, 38 and 31 patients in the SP, SP+AQ and SP+AS arms, respectively were included in this study. The concentrations on day 7 (that are associated with therapeutic efficacy) were similar between the SP, SP+AQ and SP+AS treatment arms for sulphadoxine (median [IQR] 35.25 [27.38-41.70], 34.95 [28.60-40.85] and 33.40 [24.63-44.05] mug/mL) and for pyrimethamine (56.75 [46.40-92.95], 58.75 [43.60-98.60] and 59.60 [42.45-86.63] ng/mL). There were statistically significant differences between the pyrimethamine volumes of distribution (4.65 [3.93-6.40], 4.00 [3.03-5.43] and 5.60 [4.40-7.20] L/kg; p = 0.001) and thus elimination half-life (3.26 [2.74 -3.82], 2.78 [2.24-3.65] and 4.02 [3.05-4.85] days; p < 0.001). This study confirmed the lower SP concentrations previously reported for young children when compared with adult malaria patients. CONCLUSION: Despite slight differences in pyrimethamine volumes of distribution and elimination half-life, these data show similar exposure to SP over the critical initial seven days of treatment and support the current use of SP in combination with either AQ or AS for uncomplicated falciparum malaria treatment in young Malian children. DA - 2011 DB - OpenUCT DO - 10.1186/1475-2875-10-275 DP - University of Cape Town J1 - Malaria Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali TI - Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali UR - http://hdl.handle.net/11427/14527 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14527
dc.identifier.urihttp://dx.doi.org/10.1186/1475-2875-10-275
dc.identifier.vancouvercitationTekete M, Toure S, Fredericks A, Beavogui A, Sangare C, Evans A, et al. Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali. Malaria Journal. 2011; http://hdl.handle.net/11427/14527.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDivision of Clinical Pharmacologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2011 Tekete et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceMalaria Journalen_ZA
dc.source.urihttp://www.malariajournal.com/en_ZA
dc.subject.otherPharmacokineticen_ZA
dc.subject.otherCombination therapyen_ZA
dc.subject.otherSulphadoxineen_ZA
dc.subject.otherPyrimethamineen_ZA
dc.subject.otherAmodiaquineen_ZA
dc.subject.otherArtesunate and Malariaen_ZA
dc.titleEffects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Malien_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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