Monitoramento da concentração plasmática da quinina e da mefloquina em pacientes com malária por Plasmodium falciparum no Estado do Amapá-Brasil

Abstract

The correlation between the plasma concentration of quinine and doxycycline and of mefloquine with the parasitological answer was monitored by 28 days in thirty patients with malaria by Plasmodium falciparum in the State of the Amapá. In the group (A) twelve patient received the oral scheme of quinine (3 days) + doxycycline (5 days), and in the group (B) eighteen patients received mefloquine oral unique dose (1º day). In the group (A) four sick (33,3%) presented Plasmodium resistant of the type RI, and (66,7%) were sensible (S). On average of the plasma concentration of the quinine in D1, D3 and D5 was of 2,5750μg/mL, 2,3334μg/mL and 0,532μg/mL for the (S) and of 2,4667μg/mL, 2,1784μg/mL and 0,450μg/mL for the (RI), had not difference statistical significant between those concentrations. In the group (B), patients 100% presented sensible Plasmodium. The average of the concentration plasma of the mefloquine was: D0 (0μg/mL), D1 (0,709μg/mL), D3 (0,543 μg/mL), D5 (0,361 μg/mL), D7 (0,187 μg/mL), D14 (0,125 μg/mL), D21 (0,046 μg/mL) and D28 (0μg/mL). The correlation between parasitological answer and the plasma concentration of quinine + doxicyclyne was of 94,23% for the (S) and of 76,70% for the (RI), the quinine and doxycycline adequately was absorption so much for the (S), as well as, for the (RI), therefore, was not to bad absorption of the drug the cause of the recrudescence. The results suggest that there was resistance of the P. falciparum to the administered treatment. For the patients that received mefloquine the correlation was of 91,82%, having the absorption and maintenance of the drug concentration during the period of necessary time for complete elimination of the parasites.