Intravenous ibuprofen (IV-ibuprofen) controls fever effectively in adults with acute uncomplicated Plasmodium falciparum malaria but prolongs parasitemia.
Because some febrile patients are unable to swallow or retain oral antipyretic drugs, we carried out a double-blind, placebo-controlled trial in which intravenous ibuprofen (IV-ibuprofen) was given to adults hospitalized with fever associated with acute uncomplicated falciparum malaria treated with oral artesunate plus mefloquine. Thirty patients received IV-ibuprofen 400 mg and 30 received placebo every 6 hours for 72 hours. Reduction in the area above 37.0 degrees C versus time curve was significantly greater for IV-ibuprofen than for placebo during the first 72 hours after first administration. No patients developed severe malaria; parasite clearance was delayed in the patients whose fevers were controlled by IV-ibuprofen (median 37.3 hours versus 23.7 hours in the placebo group [P = 0.0024]). This difference did not appear to be clinically important Adverse events, none considered severe, occurred equally in both groups. IV-ibuprofen was effective and well tolerated in reducing fever in febrile inpatients with malaria.
Krudsood
Srivicha
S
Department of Tropical Hygiene, Department of Clinical Tropical Medicine, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Tangpukdee
Noppadon
N
Wilairatana
Polrat
P
Pothipak
Nantaporn
N
Duangdee
Chatnapa
C
Warrell
David A
DA
Looareesuwan
Sornchai
S
D000208:Acute Disease; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use; D000077332:Artesunate; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D007275:Injections, Intravenous; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology / Q000503:physiopathology; D015767:Mefloquine / Q000627:therapeutic use; D018512:Parasitemia / Q000188:drug therapy / Q000503:physiopathology; D010963:Plasmodium falciparum / Q000187:drug effects; D016896:Treatment Outcome
D000962:Antimalarials; D037621:Artemisinins; D000077332:Artesunate; D015767:Mefloquine; D007052:Ibuprofen