Artemisinin combination therapy can result in clinical failure if oral therapy is not directly observed.
Intravenous artesunate therapy is the first-line therapy for severe malaria, and is highly efficacious when used in combination with an oral partner drug such as doxycycline or atovaquone-proguanil. However, treatment failure occurs routinely with artesunate monotherapy due to the very short half-life of this drug. In North America, experience with artesunate is limited. With the pressure to discharge patients early, administration of the essential oral partner drug is often left to the discretion of the patient. Thus, treatment failure may be commonplace if nonadherence is a factor, as was observed in the case described in the present report.
Calgary Laboratory Services, University of Calgary, Calgary, Alberta ; Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta.
Wilson W
WW
Chan
Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alberta.
Divya
D
Virmani
Calgary Laboratory Services, University of Calgary, Calgary, Alberta ; Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta ; Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alberta.
Dylan R
DR
Pillai
Adherence; Artesunate; Malaria; Plasmodium falciparum; Treatment failure