Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998
To the Editor.—Drs Lobel and Kozarsky1 provide us with their clinical opinion that mefloquine
is the drug of choice for most travelers going to malarious areas, but they
do not systematically summarize the evidence that led them to this conclusion.
We sought systematically available evidence in randomized trials (searching
from 1966 to September 1997) and identified 37 possible studies, 10 of which
met our prespecified inclusion criteria.2,3
Our review identified as a primary outcome the numbers of participants withdrawing
during the study period. This end point is a more reliable indicator of toxicity
than reported symptoms as withdrawal indicates that a threshold of tolerability
has been reached.4
Croft AM, Garner P, Squire SB. Malaria Prevention for Travelers. JAMA. 1998;279(13):990–991. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-13-jbk0401
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