A comparison of artesunate alone with combined artesunate and quinine in the parenteral treatment of acute falciparum malaria

• Main Authors: Paul N. Newton, Wirongrong Chierakul, Ronatrai Ruangveerayuth, Kamolrat Silamut, Pramote Teerapong, Srivicha Krudsood, Sornchai Looareesuwan, Nicholas J. White
• Other Authors: Mahidol University
• Format: Article
• Published: 2018
• Subjects: Immunology and Microbiology; Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/26591

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. © 2002 OUP.