Publication: Pentoxifylline as an ancillary treatment for severe falciparum malaria in Thailand
Issued Date
1998-01-01
Resource Type
ISSN
00029637
Other identifier(s)
2-s2.0-0031945993
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.58, No.3 (1998), 348-353
Suggested Citation
S. Looareesuwan, P. Wilairatana, S. Vannaphan, V. Wanaratana, C. Wenisch, M. Aikawa, G. Brittenham, W. Graninger, W. H. Wernsdorfer Pentoxifylline as an ancillary treatment for severe falciparum malaria in Thailand. American Journal of Tropical Medicine and Hygiene. Vol.58, No.3 (1998), 348-353. doi:10.4269/ajtmh.1998.58.348 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/18428
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Title
Pentoxifylline as an ancillary treatment for severe falciparum malaria in Thailand
Abstract
Pentoxifylline, an inhibitor of tumor necrosis factor, has been evaluated as an antimalarial agent in combination with artesunate in 45 patients with severe falciparum malaria. Patients were admitted to the intensive care unit at the Hospital for Tropical Diseases in Bangkok, Thailand, and randomly assigned to treatment for 72 hr with a combination of intravenously administered artesunate and 1) placebo, 2) low-dose pentoxifylline (0.83 mg/kg/hr), or 3) high-dose pentoxifylline (1.67 mg/kg/hr). All 45 patients had one or more manifestations of severe malaria such as cerebral malaria (n = 18), renal failure requiring hemodialysis (n = 9), azotemia (n = 8), jaundice (n = 25), or hyperparasitemia (n = 30). The overall severity was comparable in the three groups. Clinical outcome was assessed with respect to the parasite clearance time and the fever clearance time in all patients. In addition, a number of subsidiary outcome variables were examined in specific subgroups, including the recovery time from coma for patients with cerebral malaria, the duration of intubation in patients with respiratory distress, the number of hemodialysis treatments needed for patients with acute renal failure, and the number of units of blood administered to patients requiring transfusion. Concentrations of tumor necrosis factor were reduced in all three groups at 48 hr after treatment. No significant differences among the three treatment groups were found for any of the outcome variables examined. We conclude that the addition of pentoxifylline to artesunate therapy for severe malaria produced no evident clinical benefit.