Although it is not certain when malaria began to appear in the Korean peninsula, it is believed to have had been

Transcription

1 Pharmacotherapeutics Treatment of Korean Vivax Malaria in Korea JoonSup Yeom, MD Department of Internal Medicine, Sungkyunkwan University School of Medicine seahawks@skku.edu YunKyu Park, MD Department of Parasitology, Inha University College of Medicine yunkyu@inha.ac.kr J Korean Med Assoc 2007; 50(1): Abstract Although it is not certain when malaria began to appear in the Korean peninsula, it is believed to have had been an endemic disease until Vivax malaria reemerged in the Republic of Korea (ROK) in In the early period most of the cases occurred among soldiers stationed in the DMZ and the adjacent region. In order to cope with malaria, the soldiers at risk received chemoprophylaxis with chloroquine and primaquine. The regimen for the treatment of vivax malaria in Korea was established in 1950's. Primaquine was introduced in 1951, and the field testing during the Korean War demonstrated that the combination of three days of chloroquine administration with fourteen days of primaquine reliably prevented the recurrence of vivax malaria. The regimen has been used since then, but there were some controversies as to whether or not to start chloroquine and primaquine on the same day. Most of the current treatment guidelines recommend the use of primaquine for fourteen days to overlap with blood schizonticide agents such as chloroquine and routine tests for G6PD deficiency before use. Previous data showed that the G6PD deficiency rate has been found very low among Koreans. Thus, it is not always necessarily mandatory to test for G6PD deficiency among Korean patients. Keywords : Vivix Malaria; Chloroquine; Primaquine; Glucose6phosphate dehydrogenase 88

2 Treatment of Korean Vivax Malaria in Korea 89

3 Yeom JS. Park YK Antimalarial therapy for vivax malaria in Korea (for Adult) Regimen A Day 0 Day 1* Day 2 Day 3 ~ Day 16 Duration chloroquine base* 10mg/kg po then 5mg/kg qd 5mg/kg qd 3days 5mg/kg po 6hrs after primaquine base 0.25mg/kg qd 14days Regimen A Day 0 Day 1* Day 2 Day 3 - Day 13 Duration chloroquine base 10mg/kg po then 5mg/kg qd 5mg/kg qd 3days 5mg/kg po 6hrs after primaquine base 0.25mg/kg qd 0.25mg/kg qd 0.25mg/kg qd 0.25mg/kg qd 14days * : 24 hours after first chloroquine given on Day 0 : 48 hours after first chloroquine given on Day 0 : In regimen A and B, chloroquine can be given in different way: 5mg/kg of chloroquine can be given for 3 times on 12 hours interval after first dose (10mg/kg). : 1 tablet of chloroquine phosphate (250mg salt) = 156mg chloroquine base 1 tablet of hydroxychloroquine (200mg salt) = 155mg chloroquine base : 1 tablet of primaquine phosphate (26.3mg) = 15mg primaquine base 90

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