Comparison of artesunate and quinine in the treatment of severe falciparum malaria: a randomized control trial

Abstract

Background: Severe malaria is a medical emergency that required prompt clinical assessment and management. Very few studies underwent to evaluate the best possible treatment for severe malaria. Methods: This is a prospective, randomized, open-labeled, study to evaluate the efficacy and safety of artesunate compared with quinine. Totally, 50 patients were included in each group. Patients above 18 years, peripheral smear positive and fulfilling the WHO criteria were included. The endpoint of the study was fever clearance time (FCT), parasite clearance time (PCT) and coma resolution time (CRT), and the adverse effect if any were compared for safety analysis. Results: FCT and PCT were much less with artesunate (29.64 and 39.72 hrs) as compared to quinine (51.12 and 55.20 hrs). CRT was less with quinine (25.80 hrs) than artesunate (42 hrs). The incidence of adverse effects such as hypoglycemia and QT prolongation are significant with quinine compared to artesunate. Conclusions: Artesunate is a better alternative for severe malaria with minimal side effects.