Safety and Effectiveness of Intravenous Artesunate for Treatment of Severe Malaria in the United States-April 2019 Through December 2020.
Clin Infect Dis
; 73(11): 1965-1972, 2021 12 06.
Article
em En
| MEDLINE
| ID: mdl-34314501
ABSTRACT
BACKGROUND:
Severe malaria can be deadly and requires treatment with intravenous artesunate (IVAS). The Centers for Disease Control and Prevention provided IVAS starting 1 April 2019 for all patients with severe malaria in the United States. This study describes the safety and effectiveness of IVAS in these patients.METHODS:
Patients meeting criteria for severe malaria April 2019-December 2020 who received IVAS were included. Demographic, clinical, laboratory, adverse event, and outcome information were collected. Clinical presentation, time to reach 1% and 0% parasitemia, adverse events, and death were described using proportions, medians, interquartile range (IQR), and tests of significance for differences in proportions.RESULTS:
Of 280 patients included, the majority were male (61.4%), Black (75.0%), with a median age of 35 years (IQR 15.8-53.9). Most had Plasmodium falciparum (83.6%) with median parasitemia of 8.0% (IQR 4.6-13.2). Of 170 patients with information, 159 (93.5%) reachedâ ≤1% parasitemia by the third IVAS dose with a median time of 17.6 hours (IQR 10.8-28.8), and 0% parasitemia in a median of 37.2 hours (IQR 27.2-55.2). Patients with parasite densitiesâ >10% and those requiring adjunct therapy had significantly higher parasite clearance times. Adverse events associated with IVAS were reported in 4.8% (nâ =â 13 of 271). Eight patients had post-artesunate delayed hemolysis that resolved. There were 5 (1.8%) deaths, all attributable to severe malaria.CONCLUSIONS:
IVAS is a safe and effective drug for the treatment of severe malaria in the United States; timely administration can be lifesaving.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Malária Falciparum
/
Artemisininas
/
Malária
/
Antimaláricos
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article