FIG. 10.

Time to recrudescence following treatment with mefloquine at 25 mg/kg as a function of MIC in vivo and killing rates (k₁). The z axis is the time to recrudescence, the y axis is the killing rate of mefloquine (k₁), and the x axis is the MIC in vivo. The pharmacokinetic parameters used in the simulation were the population mean values as described previously from studies in northwestern Thailand (11). Nonraised rectangles represent two possible scenarios: either the patient is cured or at day 7 the parasites are still detectable. This illustrates that for relatively drug-sensitive parasites (MIC, < 500 ng/ml) the infections are all cured with high killing rates and that with low killing rates recrudescences occur long after the conventional follow-up period of 28 days. Conversely, with highly resistant parasites, long follow-up (i.e., >42 days) is not necessary.