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Intravenous artesunate for treatment of patients with severe malaria: position statement of TropNet
Severe falciparum malaria is an acute emergency with a very high case fatality rate, if left untreated. The condition warrants immediate onset of therapy with the most rapidly effective drug regimen possible. Quinine, the current drug of choice in Europe and the only licensed antimalarial for i.v.-use, is becoming increasingly unavailable. Thus, the survival of malaria patients is severely threatened due to supply problems. Recent studies have shown a clinical advantage for use of i.v. artesunate versus i.v. quinine in patient survival and reduction of adverse events in severe malaria. A meta-analysis of recent work in Asia showed a highly significant mortality odds ratio of 0.57 in favour of treatment with i.v. artesunate. In the largest study of this series, mortality was reduced from 22% in patients treated with i.v. quinine to 15% in those receiving i.v. artesunate (
