A Comparison of Artesunate Alone with Combined Artesunate and Quinine in the Parenteral Treatment of Acute Falciparum Malaria
Kamolrat Silamut, Nicholas J. White, Paul N. Newton, Pramote Teerapong, Ronatrai Ruangveerayuth, Sornchai Looareesuwan, Srivicha Krudsood, Wirongrong ChierakulAffiliations
Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd, Bangkok 10400, Thailand; phone +66 2 246 0832 fax +66 2 246 7795; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Raddiffe Hospital, Oxford, UK
In some areas clinicians have combined parenteral artesunate and quinine in the belief that the 2 drugs would be additive or synergistic in severe malaria. A randomized comparison of the effectiveness of intravenous (iv) artesunate versus iv artesunate and iv quinine together on parasite clearance was conducted in 1998/99 amongst 69 patients with uncomplicated and severe Plasmodium falciparum malaria in western Thailand. The parasite clearance time did not differ significantly between the 2 treatment groups (P = 0.12), but adverse events were significantly more frequent in the artesunate plus quinine group (P = 0.05). Quinine did not have a significant antipyretic effect and artesunate did not affect the electrocardiographic QTc interval. There is no benefit evident from combining parenteral administration of these 2 antimalarial drugs in the acute phase of treatment.
Transactions of the Royal Society of Tropical Medicine and Hygiene ปี 2544, September-October ปีที่: 95 ฉบับที่ 5 หน้า 519-523
Thailand, chemotherapy, malaria, quinine, Artesunate, Drug combinations, Electrocardiography, Fever, Plasmodium falciparum