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Fluids & Electrolytes
FRIDAY, March 18 (HealthDay News) -- Treatment of severe malaria with artesunate is superior to quinine for both adults and children, according to a review published in the Cochrane Database of Systematic Reviews.
David Sinclair, B.M.B.Ch., from the Liverpool School of Tropical Medicine in the United Kingdom, and colleagues compared artesunate with quinine for the treatment of severe malaria. Literature searches identified eight randomized controlled trials comparing intravenous, intramuscular, or rectal artesunate treatment with intravenous or intramuscular quinine in 1,664 adults and 5,765 children who were unable to take oral medications. The primary outcome measured was all-cause death.
The investigators found that artesunate treatment significantly reduced the risk of mortality for adults and children (relative risks, 0.61 and 0.76, respectively). An increase in the incidence of neurological sequelae was seen in children treated with artesunate, but the majority were transient, and there was no significant difference at follow-up 28 days later.
"There is now adequate evidence to be confident of the results in both adults and children," the authors write. "Intravenous artesunate should be the treatment of choice for adults and children presenting with severe malaria in any geographical region."
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