Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial

被引：0

作者：

Faiz, MA ^{[1
]}

Bin Yunus, E ^{[1
]}

Rahman, MR ^{[1
]}

Islam, F ^{[1
]}

Hoque, MG ^{[1
]}

Hasan, MU ^{[1
]}

Samad, R ^{[1
]}

Aung, S ^{[1
]}

Thein, S ^{[1
]}

Than, M ^{[1
]}

Thwe, Y ^{[1
]}

Ohn, KM ^{[1
]}

Hla, S ^{[1
]}

Lwin, S ^{[1
]}

Htut, Y ^{[1
]}

Lin, K ^{[1
]}

Kyaw, MP ^{[1
]}

Win, N ^{[1
]}

Aung, WN ^{[1
]}

Win, M ^{[1
]}

Oo, AZ ^{[1
]}

Aung, Z ^{[1
]}

Shein, OM ^{[1
]}

Kyi, MM ^{[1
]}

Myint, WW ^{[1
]}

Pyar, KP ^{[1
]}

Nyein, K ^{[1
]}

Win, KK ^{[1
]}

Mishra, SK ^{[1
]}

Mohanty, S ^{[1
]}

Pattnaik, RB ^{[1
]}

Acharya, SK ^{[1
]}

Mohanty, A ^{[1
]}

Mohapatra, D ^{[1
]}

Tijtra, E ^{[1
]}

Anstey, N ^{[1
]}

Price, R ^{[1
]}

Handoyo, T ^{[1
]}

Gampamola, D ^{[1
]}

Kenangalem, E ^{[1
]}

Takaendengan, D ^{[1
]}

Hardiyanto ^{[1
]}

Lampat, A ^{[1
]}

Harijanto, P ^{[1
]}

Dondorp, AE ^{[1
]}

Nosten, F ^{[1
]}

Day, N ^{[1
]}

Stepniewska, K ^{[1
]}

Tipmanee, P ^{[1
]}

Douthwaite, S ^{[1
]}

机构：

[1] Mahidol Univ, Fac Trop Med, Bangkok 10400, Thailand

来源：

LANCET | 2005年 / 366卷 / 9487期

基金：

英国惠康基金;

关键词：

D O I：

暂无

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background In the treatment of severe malaria, intravenous artesunate is more rapidly acting than intravenous quinine in terms of parasite clearance, is safer, and is simpler to administer, but whether it can reduce mortality is uncertain. Methods We did an open-label randomised controlled trial in patients admitted to hospital with severe falciparum malaria in Bangladesh, India, Indonesia, and Myanmar. We assigned individuals intravenous artesunate 2.4 mg/kg bodyweight given as a bolus (n=730) at 0, 12, and 24 h, and then daily, or intravenous quinine (20 mg salt per kg loading dose infused over 4 h then 10 mg/kg infused over 2-8 h three times a day; n=731). Oral medication was substituted when possible to complete treatment. Our primary endpoint was death from severe malaria, and analysis was by intention to treat. Findings We assessed all patients randomised for the primary endpoint. Mortality in artesunate recipients was 15% (107 of 730) compared with 22% (164 of 731) in quinine recipients; an absolute reduction of 34.7% (95% CI 18.5-47.6%; p=0.0002). Treatment with artesunate was well tolerated, whereas quinine was associated with hypoglycaemia (relative risk 3.2, 1.3-7.8; p=0.009). Interpretation Artesunate should become the treatment of choice for severe falciparum malaria in adults.

引用

页码：717 / 725

页数：9

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