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Evidence summaries

Artemether for Severe Malaria

Artemether appears to be more effective than quinine in children and adults. Artemether compared to artesunate has not been extensively studied, but in adults it appears inferior. Level of evidence: "B"

The quality of evidence is downgraded by imprecise results.

Summary

A Cochrane review [Abstract] 1 included 19 studies with a total of 2874 subjects with severe malaria.

Artemether versus quinine: for children there is probably little or no difference in the risk of death between intramuscular artemether and quinine. For adults, treatment with intramuscular artemether probably results in fewer deaths than treatment with quinine.

Artemether versus artesunate: no direct comparisons in children exist. For adults, mortality is probably higher with intramuscular artemether

Clinical comments

These findings are consistent with the WHO recommendations that artesunate is the drug of choice, but artemether is acceptable when artesunate is not available.

Note

Links

Abstract and full text in Cochrane database  http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010678.pub3/full (licence for full text required)

Abstract in McMaster database  (licence required)

Date of latest search: 7 September 2018

References

  • Esu EB, Effa EE, Opie ON et al. Artemether for severe malaria. Cochrane Database Syst Rev 2019;(6):CD010678. [PubMed]

Primary/Secondary Keywords