Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial
| Autor: | Faiz, MA, Bin Yunus, E, Rahman, MR, Islam, F, Hoque, MG, Hasan, MU, Samad, R, Aung, S, Thein, S, Than, M, Thwe, Y, Ohn, KM, Hla, S, Lwin, S, Htut, Y, Lin, K, Kyaw, MP, Win, N, Aung, WN, Win, M, Oo, AZ, Aung, Z, Shein, OM, Kyi, MM, Myint, WW, Pyar, KP, Nyein, K, Win, KK, Mishra, SK, Mohanty, S, Pattnaik, RB, Acharya, SK, Mohanty, A, Mohapatra, D, Tijtra, E, Anstey, N, Price, R, Handoyo, T, Gampamola, D, Kenangalem, E, Takaendengan, D, Lampat, A, Harijanto, P, Dondorp, AE, Nosten, F, Day, N, Stepniewska, K, Tipmanee, P, Douthwaite, S, Silamut, K, Proux, S, Pongsawat, K, White, N, Grp, SEAQUAMAT |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent 030231 tropical medicine Artesunate Loading dose law.invention Antimalarials 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Bolus (medicine) Randomized controlled trial law Internal medicine medicine Clinical endpoint Humans 030212 general & internal medicine Malaria Falciparum Quinine Intention-to-treat analysis business.industry General Medicine medicine.disease Artemisinins 3. Good health Survival Rate chemistry Child Preschool Female business Sesquiterpenes Malaria medicine.drug |
| DOI: | 10.1016/s0140-6736(05)67176-0 |
| Popis: | BACKGROUND: In the treatment of severe malaria, intravenous artesunate is more rapidly acting than intravenous quinine in terms of parasite clearance, is safer, and is simpler to administer, but whether it can reduce mortality is uncertain. METHODS: We did an open-label randomised controlled trial in patients admitted to hospital with severe falciparum malaria in Bangladesh, India, Indonesia, and Myanmar. We assigned individuals intravenous artesunate 2.4 mg/kg bodyweight given as a bolus (n=730) at 0, 12, and 24 h, and then daily, or intravenous quinine (20 mg salt per kg loading dose infused over 4 h then 10 mg/kg infused over 2-8 h three times a day; n=731). Oral medication was substituted when possible to complete treatment. Our primary endpoint was death from severe malaria, and analysis was by intention to treat. FINDINGS: We assessed all patients randomised for the primary endpoint. Mortality in artesunate recipients was 15% (107 of 730) compared with 22% (164 of 731) in quinine recipients; an absolute reduction of 34.7% (95% CI 18.5-47.6%; p=0.0002). Treatment with artesunate was well tolerated, whereas quinine was associated with hypoglycaemia (relative risk 3.2, 1.3-7.8; p=0.009). INTERPRETATION: Artesunate should become the treatment of choice for severe falciparum malaria in adults. |
| Databáze: | OpenAIRE |
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