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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Malaria Journal 1/2012

Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium

Zeitschrift:
Malaria Journal > Ausgabe 1/2012
Autoren:
Annemarie R Kreeftmeijer-Vegter, Perry J van Genderen, Leo G Visser, Wouter FW Bierman, Jan Clerinx, Cees KW van Veldhuizen, Peter J de Vries
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-2875-11-102) contains supplementary material, which is available to authorized users.

Competing interests

ARKV is PhD fellow, employed by ACE Pharmaceuticals; CKWVV is pharmacist for ACE Pharmaceuticals B.V.

Authors' contributions

ARKV, CKWVV and PJDV conceived and designed the study. ARKV and PJDV analysed and interpreted the data. PVG, LV, WB and JC helped acquire the data. All authors were involved in critical revision and approval of the paper.

Abstract

Background

Intravenous (IV) artesunate is the treatment of choice for severe malaria. In Europe, however, no GMP-manufactured product is available and treatment data in European travellers are scarce. Fortunately, artesunate became available in the Netherlands and Belgium through a named patient programme. This is the largest case series of artesunate treated patients with severe malaria in Europe.

Methods

Hospitalized patients treated with IV artesunate between November 2007 and December 2010 in the Netherlands and Belgium were retrospectively evaluated. Patient characteristics, treatment and clinical outcome were recorded on a standardized form and mortality, parasite clearance times and the occurrence of adverse events were evaluated.

Results

Of the 68 treated patients, including 55 with severe malaria, two patients died (2/55 = 3.6%). The mean time to 50% parasite clearance (PCT50), 90% and 99% were 4.4 hours (3.9 - 5.2), 14.8 hours (13.0 - 17.2), and 29.5 hours (25.9 - 34.4) respectively. Artesunate was well tolerated. However, an unusual form of haemolytic anaemia was observed in seven patients. The relationship with artesunate remains uncertain.

Conclusions

Data from the named patient programme demonstrate that IV artesunate is effective and well-tolerated in European travellers lacking immunity. However, increased attention needs to be paid to the possible development of haemolytic anaemia 2-3 weeks after start of treatment.
Treatment of IV artesunate should be limited to the period that IV treatment is required and should be followed by a full oral course of an appropriate anti-malarial drug.
Zusatzmaterial
Authors’ original file for figure 1
12936_2012_2087_MOESM1_ESM.jpeg
Literatur
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