Comparison of artemether and quinine in the treatment of severe falciparum malaria in south-east Thailand

Transactions of the Royal Society of Tropical Medicine and Hygiene
J KarbwangT Harinasuta

Abstract

One hundred and two Thai patients with severe falciparum malaria (92 males and 10 females) were allocated at random to receive either the standard regimen of quinine infusion (52 cases) or intramuscular artemether (50 cases). The patients in both groups had comparable admission clinical and laboratory data. Artemether gave a better survival rate (87.2% vs. 63.3%) and parasite clearance time (54 vs. 78 h) than quinine. Fever clearance times (79 h vs. 84 h) and time to recovery of consciousness (48 h in both groups) were comparable. Previous treatment with quinine or mefloquine had no influence on treatment outcome. The most common adverse effect in patients treated with quinine was tinnitus. Two patients had severe hearing impairment which resolved within 1 week after the end of treatment. Mild, transient pain was noted at the injection site of artemether but no abscess formed. QTc wave prolongation was seen in most patients receiving quinine; however, no arrhythmia was observed despite the high concentration of quinine in some patients who had received quinine before admission. Complications developed in 7 survivors in each treatment group. No patient in the artemether group had neurological sequelae after recovery of conscious...Continue Reading

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Citations

Jan 31, 2002·Transactions of the Royal Society of Tropical Medicine and Hygiene·UNKNOWN Artemether-Quinine Meta-analysis Study Group
May 1, 1997·Transactions of the Royal Society of Tropical Medicine and Hygiene·S MohantyJ Patnaik
Jul 1, 1997·Transactions of the Royal Society of Tropical Medicine and Hygiene·V HaT H Tran
Aug 6, 1998·Transactions of the Royal Society of Tropical Medicine and Hygiene·K CongpuongJ Karbwang
Jul 11, 1996·The New England Journal of Medicine·T H TranN J White
Jul 11, 1996·The New England Journal of Medicine·S L Hoffman
Feb 11, 2005·Postgraduate Medical Journal·C J WoodrowS Krishna
Jul 25, 2012·The American Journal of Tropical Medicine and Hygiene·Nathalie DournonStéphane Jauréguiberry
Oct 30, 2004·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·A SowunmiA O Arowojolu
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