Intravenous Artesunate for the Treatment of Severe Malaria

Abstract

Artesunate, a new antimalarial currently available through the CDC, appears to be highly effective, better tolerated than quinidine, and not hampered by accessibility issues. If it were to be FDA approved and commercially available, it would be the preferred agent for the treatment of severe malaria in the US.

Availability and prescription practice of anti-malaria drugs in the private health sector in Yemen

“…Moreover, one study recommended that if the drug is approved by the US Food and Drug Administration (FDA) and commercially available, it would be the preferred agent for treatment of severe malaria in the USA [17]. On the other hand, another recent study reported that there was no evidence that treatment for severe malaria with parental artemisinin-derivatives was associated with lower mortality or long-term morbidity compared with parental quinine [18]. In this study, quinine and artemether injections were available and used frequently for the treatment of severe malaria.…”

Inhibition of Cytochrome bc1 as a Strategy for Single-Dose, Multi-Stage Antimalarial Therapy

“…Although oral therapy is the most common treatment route for uncomplicated malaria, IV drug administration is still the standard of care for infants and patients with severe disease. 30,31 For children, rectal formulations of artesunate have also been proposed for pre-referral treatment in cases where parenteral therapy will be delayed or oral administration is not possible. 32 Our findings with ELQ-400 suggest that topical treatment may be a viable alternative, which could decrease the risk of blood-borne infections, reduce the medical training required to provide treatment, and ultimately provide safer, more accessible care for patients.…”

Intravenous artesunate versus intravenous quinine in the treatment of severe falciparum malaria: a retrospective evaluation from a UK centre

“…Large randomized controlled trials on adults in Asia and Africa, and in African children, demonstrated that severe FM patients treated with parenteral AS had shorter parasite-clearance time, fewer side effects, and lower mortality compared to those treated with IV quinine, and an economic evaluation indicated AS use in South-East Asia was cost-effective. [11][12][13][14][15][16][17][18][19][20][21][22][23] In light of this evidence, current WHO guidelines recommend IV AS as first-line treatment in severe FM. 24,25 In UK guidelines, IV AS is currently listed as an alternative to IV Q as the drug of choice for treating severe FM in adults.…”