title: A comparison of artesunate alone with combined artesunate and quinine in the parenteral treatment of acute falciparum malaria.
abstract: 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 (i.v.) artesunate versus i.v. artesunate and i.v. 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.
authors.affiliation: Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: P N
authors.initials: PN
authors.lastname: Newton
authors.forename: W
authors.initials: W
authors.lastname: Chierakul
authors.forename: R
authors.initials: R
authors.lastname: Ruangveerayuth
authors.forename: K
authors.initials: K
authors.lastname: Silamut
authors.forename: P
authors.initials: P
authors.lastname: Teerapong
authors.forename: S
authors.initials: S
authors.lastname: Krudsood
authors.forename: S
authors.initials: S
authors.lastname: Looareesuwan
authors.forename: N J
authors.initials: NJ
authors.lastname: White
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000008:administration & dosage*; D037621:Artemisinins; D000077332:Artesunate; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011803:Quinine / Q000008:administration & dosage*; D012717:Sesquiterpenes / Q000008:administration & dosage*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D000077332:Artesunate; D011803:Quinine