title: Pentoxifylline as a supportive agent in the treatment of cerebral malaria in children.
abstract: In an open, randomized, controlled therapeutic trial, 56 children with cerebral malaria (CM) were randomly assigned to receive standard quinine regimen with or without pentoxifylline (10 mg/kg/day by continuous intravenous infusion). Pentoxifylline exerted an inhibitory effect on the synthesis of tumor necrosis factor (TNF), a possible mediator of CM. The 26 children who received pentoxifylline had significantly shorter comas than controls (median, 6 vs. 46 h; P < .001) Pentoxifylline recipients showed a trend toward a lower mortality, with a borderline significant difference (P = .055). The better outcome in the pentoxifylline group was associated with a decline in TNF serum levels on the third day of treatment in a few subjects that was not seen in controls. While alternative or concurrent mechanisms of action may be of some relevance, larger double-blind trials are needed to determine whether pentoxifylline has a therapeutic role in CM.
authors.affiliation: Institute of Immunology, University of Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Di Perri
authors.forename: I G
authors.initials: IG
authors.lastname: Di Perri
authors.forename: G B
authors.initials: GB
authors.lastname: Monteiro
authors.forename: S
authors.initials: S
authors.lastname: Bonora
authors.forename: C
authors.initials: C
authors.lastname: Hennig
authors.forename: M
authors.initials: M
authors.lastname: Cassatella
authors.forename: R
authors.initials: R
authors.lastname: Micciolo
authors.forename: S
authors.initials: S
authors.lastname: Vento
authors.forename: S
authors.initials: S
authors.lastname: Dusi
authors.forename: D
authors.initials: D
authors.lastname: Bassetti
mesh_terms: D000293:Adolescent; D002063:Burundi; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016779:Malaria, Cerebral / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D010431:Pentoxifylline / Q000627:therapeutic use*; D011803:Quinine / Q000627:therapeutic use; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D014409:Tumor Necrosis Factor-alpha; D011803:Quinine; D010431:Pentoxifylline