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Title: Life-saving rectal artesunate for complicated malaria in children
Authors: Krisana Pengsaa
Chukiat Sirivichayakul
Kesara Na-Bangchang
Itthipon Thaiarporn
Anong Chaivisuth
Amnaj Wongsuwan
Phanorsri Attanath
Chanathep Pojjaroen-Anant
Pataraporn Wisetsing
Pornthep Chanthavanich
Arunee Sabchareon
Mahidol University
Thammasat University
Thong Pha Phum Hospital
Paholpolpayuhasena Hospital
Mae Sot General Hospital
Keywords: Medicine
Issue Date: 1-May-2005
Citation: Southeast Asian Journal of Tropical Medicine and Public Health. Vol.36, No.3 (2005), 597-601
Abstract: We report the effectiveness of two regimens of rectal artesunate formulation in treating 13 Thai children with cerebral/complicated falciparum malaria. The drug was given at an initial dose of 40 mg/kg bodyweight, in 3 or 4 divided doses in the first 24 hours, followed by 10 mg/kg bodyweight once daily for three consecutive days. Mefloquine, at a dose of 15 mg/kg bodyweight was given orally at 72 hours after the initial dose of artesunate, followed by 10 mg/kg bodyweight 6 hours later. Three cases with cerebral malaria gained consciousness within 20 hours of artesunate administration. The median time required for reduction of parasitemia by 90% of the initial value (P 90) in 13 children was 11.2 hours. No recrudescence was observed in any of the patients during the 28-day follow-up period. Plasma concentrations of artesunate and dihydroartemisinin (active plasma metabolite of artesunate) measured in two patients who received the high initial dose regimen (20 mg/ kg bodyweight) suggested rapid absorption and adequate plasma concentrations of both compounds following the administration of artesunate via the rectal route. Further studies for the optimized regimen of rectal artesunate in the treatment of cerebral/complicated childhood falciparum malaria in areas of multidrug resistance are warranted.
ISSN: 01251562
Appears in Collections:Scopus 2001-2005

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