Intravenous Artesunate Reduces Parasite Clearance Time, Duration of Intensive Care, and Hospital Treatment in Patients With Severe Malaria in Europe: The TropNet Severe Malaria Study

Florian Kurth; Michel Develoux; Matthieu Mechain; Jan Clerinx; Spinello Antinori; Ida E Gjørup; Joaquím Gascon; Kristine Mørch; Emanuele Nicastri; Michael Ramharter; Alessandro Bartoloni; Leo Visser; Thierry Rolling; Philipp Zanger; Guido Calleri; Joaquín Salas-Coronas; Henrik Nielsen; Gudrun Just-Nübling; Andreas Neumayr; Anna Hachfeld; Matthias L Schmid; Pietro Antonini; Peter Pongratz; Peter Kern; José Saraiva da Cunha; Antoni Soriano-Arandes; Mirjam Schunk; Norbert Suttorp; Christoph Hatz; Thomas Zoller; TropNet Severe Malaria Investigator Group

doi:10.1093/cid/civ575

Intravenous Artesunate Reduces Parasite Clearance Time, Duration of Intensive Care, and Hospital Treatment in Patients With Severe Malaria in Europe: The TropNet Severe Malaria Study

Clin Infect Dis. 2015 Nov 1;61(9):1441-4. doi: 10.1093/cid/civ575. Epub 2015 Jul 17.

Authors

Florian Kurth¹, Michel Develoux², Matthieu Mechain³, Jan Clerinx⁴, Spinello Antinori⁵, Ida E Gjørup⁶, Joaquím Gascon⁷, Kristine Mørch⁸, Emanuele Nicastri⁹, Michael Ramharter¹⁰, Alessandro Bartoloni¹¹, Leo Visser¹², Thierry Rolling¹³, Philipp Zanger¹⁴, Guido Calleri¹⁵, Joaquín Salas-Coronas¹⁶, Henrik Nielsen¹⁷, Gudrun Just-Nübling¹⁸, Andreas Neumayr¹⁹, Anna Hachfeld²⁰, Matthias L Schmid²¹, Pietro Antonini²², Peter Pongratz¹, Peter Kern²³, José Saraiva da Cunha²⁴, Antoni Soriano-Arandes²⁵, Mirjam Schunk²⁶, Norbert Suttorp¹, Christoph Hatz¹⁹, Thomas Zoller¹⁹; TropNet Severe Malaria Investigator Group

Affiliations

¹ Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Germany.
² Hôpital Saint-Antoine, Paris.
³ Section Tropical Medicine and Clinical International Health, Division of Infectious and Tropical Diseases, Department of Medicine, University Hospital Centre, Bordeaux, France.
⁴ Institute of Tropical Medicine, Antwerp, Belgium.
⁵ Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Italy.
⁶ Infectious Diseases Unit, Herlev University Hospital, Copenhagen, Denmark.
⁷ ISGlobal, Barcelona Centre for International Health Research, Spain.
⁸ National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway.
⁹ National Institute of Infectious Diseases Lazzaro Spallanzani, Rome, Italy.
¹⁰ Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Austria.
¹¹ SOD Malattie Infettive e Tropicali, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
¹² Department of Infectious Diseases, Leiden University Medical Centre, The Netherlands.
¹³ Department of Internal Medicine I, Section Tropical Medicine, University Medical Center Hamburg-Eppendorf Department of Clinical Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg.
¹⁴ Institute of Public Health, University of Heidelberg Institute of Tropical Medicine, University of Tübingen, Germany.
¹⁵ Travel Medicine Unit, Department of Infectious Diseases, Amedeo di Savoia Hospital-ASLTO2, Turin, Italy.
¹⁶ Tropical Medicine Unit, Hospital de Poniente, El Ejido, Spain.
¹⁷ Department of Infectious Diseases, Aalborg University Hospital, Denmark.
¹⁸ Department of Internal Medicine II, Section Infectious diseases and Tropical Medicine, University Hospital Frankfurt/Main, Germany.
¹⁹ Swiss Tropical and Public Health Institute, Basel.
²⁰ Department of Infectious Diseases, Bern University Hospital and University of Bern, Switzerland.
²¹ Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
²² Clinica Luganese, Lugano, Switzerland.
²³ Comprehensive Infectious Diseases Center, Department of Internal Medicine III, Ulm University Hospital, Germany.
²⁴ Centro Hospitalar e Universitário de Coimbra, Portugal.
²⁵ Hospital Universitari Joan XXIII, Tarragona, Spain.
²⁶ Abteilung für Infektions- und Tropenmedizin, Medizinische Poliklinik, University of Munich, Germany.

PMID: 26187021
DOI: 10.1093/cid/civ575

Abstract

Intravenous artesunate improves survival in severe malaria, but clinical trial data from nonendemic countries are scarce. The TropNet severe malaria database was analyzed to compare outcomes of artesunate vs quinine treatment. Artesunate reduced parasite clearance time and duration of intensive care unit and hospital treatment in European patients with imported severe malaria.

Keywords: Plasmodium falciparum; artesunate; clinical study; quinine; severe malaria.

Publication types

Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Administration, Intravenous
Adult
Antimalarials / administration & dosage*
Artemisinins / administration & dosage*
Artesunate
Europe
Female
Humans
Malaria / drug therapy*
Male
Quinine / administration & dosage
Retrospective Studies
Time Factors
Treatment Outcome

Substances

Antimalarials
Artemisinins
Artesunate
Quinine