Document Type
Article
Publication Date
2010
Abstract
OBJECTIVE: To review the pharmacodynamics and pharmacotherapeutic use of intravenous artesunate for the treatment of severe malaria.
DATA SOURCES: Literature was retrieved through PubMed (1999 March 2010), MEDLINE (1996 March 2010), and the Centers for Disease Control and Prevention (CDC), using the search terms artemisinin, artesunate, malaria, and severe malaria. In addition, reference citations from publications identified were reviewed.
STUDY SELECTION AND DATA EXTRACTION: All articles in English that were identified from the data sources were reviewed. Focus was placed on post-marketing trials examining the safety and efficacy of artesunate in comparison with other regimens.
DATA SYNTHESIS: The treatment of severe malaria requires prompt, safe, and effective intravenous antimalarials. Many oral and intravenous agents are available worldwide for the treatment of malaria; however, quinidine has been the only option for parenteral therapy in the US. Furthermore, this product's lack of availability as well as its adverse safety profile have created a treatment option gap. Recently, intravenous artesunate was approved by the Food and Drug Administration (FDA) for investigational drug use and distribution by the CDC. Three major studies regarding the use of intravenous artesunate are reviewed, in addition to the World Health Organization's malaria treatment guidelines. While there are no published head-to-head trials of intravenous artesunate versus intravenous quinidine for severe malaria, several international studies comparing intravenous quinine and artesunate concluded that artesunate has the highest treatment success, with lower incidence of adverse events. In addition, other literature is reviewed regarding counterfeit and other issues associated with artesunate.
CONCLUSIONS: Artesunate, a new antimalarial currently available through the CDC, appears to be highly effective, better tolerated than quinidine, and not hampered by accessibility issues. If it were to be FDA approved and commercially available, it would be the preferred agent for the treatment of severe malaria in the US.
Recommended Citation
Hess K, Goad J, Arguin P. Intravenous Artesunate for Severe Malaria. Ann Pharmacother 2010; 44 (July/August): 1250-1258
Copyright
Sage
Included in
Animal Diseases Commons, Parasitic Diseases Commons, Pharmaceutical Preparations Commons, Pharmacy and Pharmaceutical Sciences Commons, Therapeutics Commons
Comments
This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Annals of Pharmacotherapy, volume 44, 2010 following peer review. The definitive publisher-authenticated version is available online at DOI: 10.1345/aph.1M732.