Trial country |
Treatment regimen | Blinding | SAE | Discontinuation | Lab and other | Notes | ||
TR | AC | TR | AC | |||||
P. vivax | ||||||||
Dunne 2005a India | 1) Azithromycin 1 g/day for 3 days | P | 0 | 0 | 0 | NR | NR | 2 discontinued in arm 2 because of pruritis (1) and maculopapular rash (1) |
2) Chloroquine 0.6 g on day 1 to 2, 0.3 g on day 3 | P | 0 | 0 | 2 | NR | NR | ||
Pukrittayakamee 2001 Thailand |
1) Azithromycin 0.5 g/day for 3 days | O | 0 | 0 | NR | NR | "None of the patients developed serious adverse effects as monitored by clinical symptoms and laboratory data." | |
2) Tetracycline 250 mg 4x/day for 7 days | O | 0 | 0 | NR | NR | |||
3) Doxycycline 200 mg/day for 7 days | O | 0 | 0 | NR | NR | |||
4) Clindamycin 300 mg 4x/day for 7 days | O | 0 | 0 | NR | NR | |||
P. falciparum | ||||||||
Dunne 2005b India |
1) Azithromycin 1 g/day for 3 days | P | 0 | 0 | 0 | 0 | NR | |
2) Chloroquine 0.6 g on day 1 to 2, 0.3 g on day 3 | P | 0 | 0 | 0 | 0 | NR | ||
3) Azithromycin 1 g/day for 3 days, chloroquine 0.6 g on day 1 to 2, 0.3 g on day 3 | O | 0 | 0 | 0 | 0 | NR | ||
Krudsood 2000 Thailand |
1) Azithromycin 0.5 g/day, artesunate 200 mg/day for 3 days | O | 0 | 0 | NR | NR | "Several patients had abnormal haematology and biochemistry at the beginning, but all of these improved a few weeks after treatment." | |
2) Artesunate 200 mg/day for 3 days, mefloquine 10 mg/kg on day 1 to 2, 5 mg/kg on day 3 | O | 0 | 0 | NR | NR | |||
3) Artesunate 200 mg/day for 3 days | O | 0 | 0 | NR | NR | |||
Miller 2006 Thailand |
1) Azithromycin 0.5 g 2x/day and quinine 10 mg/kg 3x/day for 3 days | O | 0 | 0 | NR | NR | Elevated ALT level (1 in each group). Resolved within 10 days of completion of therapy. | Most side effects related to quinine (tinnitus, prolonged QTc) |
2) Azithromycin 0.5 g 2x/day and quinine 10 mg/kg 3x/day for 5 days | O | 0 | 0 | NR | NR | |||
3) Azithromycin 0.5 g 3x/day and quinine 10 mg/kg 3x/day for 3 days | O | 0 | 0 | NR | NR | |||
4) Doxycycline 100 mg 2x/day and quinine 10 mg/kg 3x/day for 7 days | O | 0 | 0 | NR | NR | |||
Na‐Bangchang 1996 Thailand |
1) Azithromycin 0.5 g at start, 0.25 g at 24 hours and 48 hours, and artemether 300 mg at start | O | 0 | 0 | NR | NR | NR | "Transient mild nausea, abdominal discomfort and loss of appetite were common adverse effects." |
2) Doxycycline 100 mg 2x/day for 5 days and artemether 300 mg at start and 100 mg after 12 hours | O | 0 | 0 | NR | NR | NR | ||
Noedl 2006 Thailand |
1) Azithromycin 0.75 g 2x/day and artesunate 100 mg 2x/day for 3 days | O | 0 | 0 | 0 | 0 | NR | One participant with food poisoning withdrawn in arm 4. |
2) Azithromycin 1 g/day and artesunate 200 mg/day for 3 days | O | 0 | 0 | 0 | 0 | NR | ||
3) Azithromycin 0.75 g 2x/day and quinine 10 mg/kg 2x/day for 3 days | O | 0 | 0 | 0 | 0 | ECG: quinine groups significant prolongation of QT interval. | ||
4) Azithromycin 0.5 g 3x/day and quinine 10 mg/kg 3x/day for 3 days | O | 0 | 1 | 0 | 0 | |||
Pfizer74841 India |
1) Azithromycin 1 g/day and chloroquine 0.6 g/day for 3 days | P/O | 0/83 | 5/83 (6.0%) | 0 | 3/83 (3.6%) | “No clinical significant laboratory findings or changes in vital signs." | SEA any cause: arm 1: cerebral malaria (1), fever (4); arm 2: fever (3), convulsion (1), pneumonia (1); arm 3: fever (2), abnormal behaviour (1, TR). |
2) Azithromycin 0.5 g/day and chloroquine 0.6 g/day for 3 days | P | 0/67 | 5/67 (7.5%) | 0 | 0/67 | Discontinuations: 1 cerebral malaria and 2 malarial fever in arm 1, and 1 malarial fever in arm 3. | ||
3) Sulfadoxine‐pyrimethamine 1500mg /75 mg at start, chloroquine 0.6 g on day 1 to 2, 0.3 mg on day 3 | O | 1/80 (1.3%) | 3/80 (3.8%) | 0 | 1/80 (1.3%) | |||
Pfizer 82563 Kenya |
1) Azithromycin 1 g/day and chloroquine 0.6 g/day for 3 days | P | 0 | 1/6 (16.7%) | 0 | 0 | Similar incidence of lab abnormalities in both groups. "None were unexpected for this population." Vital signs: larger mean decrease in BP and larger mean increase in heart rate from baseline in group 2. |
One SEA in group 1 (seizures) in a person with a history of seizures. |
2) Chloroquine 0.6 g/day for 3 days | P | 0 | 0 | 0 | 0 | |||
Pfizer 82576 Ghana, Kenya, Mali, Uganda, Zambia |
1) Azithromycin 1 g/day and chloroquine 0.6 g/day for 3 days | P | 0 | 1/114 (0.9%) | 2/114 (1.8%) | 3/114 (2.6%) | "The incidence of laboratory abnormalities was similar in arm 1 and arm 3." | SEA: Dyspnoea and confusional state in arm 1, mental disorder and nephritic syndrome in arm 3 (TR) |
2) Azithromycin 0.5 g/day and chloroquine 0.6 g/day for 3 days | P | 0 | 0 | 0 | 0 | Discontinuations: arm 1: confusion 1, vomiting 2 (TR), arm 3: vomiting 2, (1 TR), jaundice 1, fever 1 (TR) | ||
3) Mefloquine 750 mg at start, 500 mg after 6 hours | P | 2/115 (1.7%) | 2/115 (1.7%) | 2/115 (1.7%) | 4/115 (3.5%) | |||
Pfizer 84227 Colombia/Surinam |
1) Azithromycin 1 g/day and chloroquine 0.6 g/day for 3 days | P | NR | 3/114 (2.6%) | NR | 6/114 (5.3%) | NR | SEA: Arm 1: complicated malaria, progressive renal failure, sepsis; arm 2: enterocolitis; arm 3: diabetic neuropathy, progressive severe anaemia. |
2) Azithromycin 0.5 g/day and chloroquine 0.6 g/day for 3 days | P | NR | 1/14 (7.1%) | NR | NR | NR | Discontinuations: Arm 1: vomiting 2, infection 2, sepsis 1, electrolyte imbalance 1; arm 3: infection 1. |
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3) Atovaquone 1000 mg/day and proguanil 400 mg/day for 3 days | P | NR | 2/116 (1.7%) | NR | 1/116 (0.9%) | NR | ||
Pfizer 84240 Indonesia |
1) Azithromycin 1 g/day and chloroquine 0.6 g/day for 3 days | P | 0 | 1/13 (7.7%) | 0 | 0 | "All treatment groups showed a similar incidence of laboratory abnormalities (1 subject in each group) with regard to normal baseline. None of the laboratory abnormalities was unexpected for this disease population." | SEA arm 1: recurrent malaria; arm 2: appendicitis |
2) Azithromycin 0.5 g/day and chloroquine 0.6 g/day for 3 days | P | 0 | 1/7 (14.3%) | 0 | 0 | |||
3) Sulfadoxine‐Pyrimethamine 1500 mg/75 mg at start, chloroquine 0.6 g on day 1 to 2, 0.3 g on day 3 | P | 0 | 0/12 | 0 | 0 | |||
Pfizer 367653 Burkina Faso, Ghana, Kenya, Mali, Senegal, Zambia |
1) Azithromycin 1 g/day and chloroquine 0.6 g/day for 3 days | O | 0/113 | 0/113 | NR | 1/113 (0.9%) | "No subjects were discontinued from the study due to abnormal laboratory test results." | SEA: dizziness and intentional self injury |
2) Mefloquine 750 mg at start, 500 mg after 6 to 10 hours | O | 1/116 (0.9%) | 2/116 (1.7%) | NR | 0/116 | Discontinuation in arm 1 because of pruritis | ||
Sykes 2009 Tanzania |
1) Azithromycine 20 mg/kg/day and artesunate 4 mg/kg/day for 3 days | O | 1/120 | Lab‐abnormalities on day 14: 18/120 |
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2) Artemether 20 mg and lumefantrine 120 mg 2x/day for <15 kg and 40 mg/240 mg 2x/day for ≥15 kg for 3 days | O | 9/129 | Lab‐abnormalities on day 14: 22/121 |
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Thriemer 2010 Bangladesh |
1) Azithromycin 1.5 g/day and artesunate 200 mg/day for 3 days. Children < 35 kg: azithromycin 30 mg/kg/day, and artesunate 4 mg/kg/day for 3 days. | O | 0 | 8 | NR | Discontinuations: Development of P. vivax ≥ day 21 | ||
2) Artemether 80 mg and lumefantrine 480 mg 2x/day for 3 days. Children < 35 kg: artemether 4 mg/kg and lumefantrine 24 mg/kg 2x/day for 3 days | O | 0 | 4 | NR | ||||
Excluded studies (P. falciparum) | ||||||||
Krudsood 2002 Thailand |
1) Azithromycin 0.5 g/day and dihydroartemisinin 80 mg/day for 3 days | O | 0 | 0 | 0 | 0 | "Some baseline laboratory parameters were affected by disease status. However, they all returned to normal within 1‐2 weeks." | |
2) Mefloquine 10 mg/kg on day 1 and 2, and 5 mg/kg on day 3, dihydroartemisinin 80 mg/day for 3 days | 0 | 0 | 0 | 0 | ||||
Pfizer 282919 India, Colombia |
1) Azithromycin 2 g/day and chloroquine 0.6 g/day for 3 days | O | 0 | NR | 0 | NR |