Treatment of Plasmodium falciparum malaria with mefloquine alone or in combination with i.v. quinine at the Department of Communicable and Tropical Diseases, Rigshospitalet, Copenhagen 1982-1988.

At the Department of Communicable and Tropical Diseases, Rigshospitalet, Denmark, mefloquine has been used since 1982 for the treatment of patients with suspected or verified chloroquine and sulfadoxine-pyrimethamine resistant P. falciparum malaria. Eighty-one patients treated with mefloquine are reviewed. Forty patients had complicated malaria; 18 were initially treated with IV quinine. Mefloquine dose for adults was 1,500 mg in one dose or divided in two with six hourly intervals. Mild gastrointestinal side effects were common; in 10 patients, the medication had to be repeated because of vomiting. No neurological or neuropsychiatric side effects were recorded in relation to treatment or during the follow up period (30 days). Temperature subsided with a mean of 2.7 days after initiation of treatment and trophozoites cleared with a mean of 3.6 days. One patient had recrudescence. Mefloquine is found safe and effective for the treatment of P. falciparum malaria and is recommended for treatment of worldwide acquired P. falciparum malaria, although patients should be monitored closely to disclose resistance.