Therapeutics
Parenteral artesunate reduced inhospital mortality more than quinine in severe falciparum malaria
Dondorp A, Nosten F, Stepniewska K, et al. Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial. Lancet 2005;366:717–25.[CrossRef][Medline]
Q What is the relative effectiveness of parenteral artesunate and parenteral quinine for patients with severe falciparum malaria?
Tropical & travel medicine
Key Words: malaria (falciparum) • antimalarials • artemisinins • quinine • sesquiterpenes
| The first 150 words of the full text of this article appear below. |
Design:
randomised controlled trial (South East Asian Quinine Artesunate Malaria Trial [SEAQUAMAT]).
Allocation:
concealed.*
Blinding:
blinded (microscopists assessing parasite counts and stages and data analysts).*
Follow up period:
to discharge.
Setting:
10 centres in Bangladesh, Myanmar (Burma), India, and Indonesia.
Patients:
1461 patients >2 years of age (mean age 28 y, 74% men) who had a diagnosis of severe malaria and a positive blood antigen stick test for Plasmodium falciparum histidine rich protein 2. Exclusion criteria: history of full treatment with quinine or an artemisinin derivative for >24 hours before admission or known allergy to artemisinin derivatives or quinine.
Intervention:
730 patients were allocated to intravenous (IV) artesunate, 2.4 mg/kg body weight given on admission and at 12 and 24 hours and once daily thereafter until oral artesunate (2 mg salt/kg/d) could be taken. Each 60 mg vial contained anhydrous artesunic acid, which was dissolved in 1 ml of 5%
Ottawa Hospital-General Campus, Ottawa, Ontario, Canada
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Evid. Based Med. 2006 11: 63a. (in Glossary)[Extract] [Full Text] [PDF]
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