Optimal Mefloquine Dosing for Malaria

The final PK/PD (1,000 virtual patients with 10 simulations) models were used to simulate optimal dosages of mefloquine in the combination regimens that provided high clinical efficacy using Monte Carlo simulations (Simulix version 2021R1, Antony, France; Lixoft SAS, 2021). The simulated dose regimens (oral administration) for mefloquine-resistant P. falciparum included: (i) 750 mg on day 1 (day 0), followed by 500 mg on day 2, (ii) 500 mg once daily for 42 days, (iii) 500 mg every 72 hours for 42 days, (iv) 500 mg every 96 hours for 42 days, and (v) 250 mg every 12 hours for 42 days. The simulated regimens for mefloquine-sensitive strains were: (i) 750 mg on day 1 and 500 mg on day 2, (ii) 500 mg on day 1 and 250 mg on day 2, (iii) 750 mg on day 1, (iv) 500 mg on day 1, and (v) 250 mg on day 1, 2, and 3. The simulated regimens are based on trials and erros until it provides the curative rate close to 100%.