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  • 2012mjou0102

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  • A.R. Kreeftmeijer-Vegter
  • P.J. van Genderen
  • L.G. Visser
  • W.F. Bierman
  • J. Clerinx
  • C.K. van Veldhuizen
  • P.J. de Vries
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 haemolyticanaemia 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 haemolyticanaemia 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.
Originele taal-2Engels
TijdschriftMalaria Journal
Volume11
Nummer van het tijdschrift102
Pagina's (van-tot)1-11
Aantal pagina's11
ISSN1475-2875
DOI's
StatusGepubliceerd - 2012

ID: 264459