gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Efficacy and safety of artesunate for the treatment of severe malaria in Europe

I.v.-Artesunate zur Behandlung der komplizierten Malaria tropica in Europa

Meeting Abstract

  • T. Zoller - Charité - Universitätsmedizin Berlin, Germany
  • T. Junghanss - Universität Heidelberg, Sektion Klinische Tropenmedizin, Heidelberg, Germany
  • A. Kapaun - Universität Heidelberg, Sektion Klinische Tropenmedizin, Heidelberg, Germany
  • I. Gjörup - University Hospital Copenhagen, Department of Infectious Diseases, Copenhagen, Denmark
  • J. Richter - Universität Düseldorf, Tropenmedizinische Ambulanz, Düsseldorf, Germany
  • M. Hugo-Persson - Hospital of Helsingborg, Department of Infectious Diseases, Helsingborg, Sweden
  • N. Suttorp - Charité – Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Berlin, Germany
  • S. Yürek - Charité - Universitätsmedizin Berlin, Institut für Transfusionsmedizin, Berlin, Germany
  • H. Flick - Charité – Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Berlin, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocTRO 01-3

DOI: 10.3205/10kit049, URN: urn:nbn:de:0183-10kit0498

Published: June 2, 2010

© 2010 Zoller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: Large multicenter trials from South-East Asia have demonstrated an improved survival for i.v.-artesunate as compared to quinine for the treatment of severe malaria. For patients with severe malaria in Europe, quinine is still the mainstay of treatment and artesunate has not been evaluated systematically in this group of patients.

Methods: In this report, a case series of 22 patients returning from malaria-endemic regions with severe malaria treated in five different European centres is analysed retrospectively.

Results: All patients survived the infection and treatment with i.v.-artesunate was effective and induced a rapid clearance of parasitaemia. In four patients from three different treatment centres, a self-limiting, but prolonged episode of haemolysis after clearance of parasitaemia was observed. After exclusion of other causes, a review of treatment data suggests that this phenomenon might have been related to treatment with i.v.-artesunate. The recurring haemolysis peaked during the third week after the first dose of i.v.-artesunate and resolved spontaneously between the 3rd and 5th week. Three patients required transfusion of red cells.

Conclusion: i.v.-artesunate is a valuable and effective alternative to quinine for the treatment of severe malaria also for European patients and should not be withheld in patients where the benefit of improved survival may outweigh the risk of potential adverse reactions. The efficacy and safety profile of i.v.-artesunate should be prospectively evaluated, particularly with regard to signs of persistent or recurring haemolysis after parasitological cure.