For severe malaria, artesunate is the answer.

摘要

Severe falciparum malaria is one of the few infections that can kill within hours. It requires swift and effective therapy, which is best delivered intravenously; unlike other causes of coma, most survivors of cerebral malaria do not have serious sequelae. Mortality depends largely on how soon the patient is treated, but even in expert centres, one in five patients might die. Choosing the best antimalarial drug for severe malaria has been an important and difficult question. In The Lancet, this question has been answered definitively: artesunate is superior to quinine when both are given intravenously. Arjen Dondorp and colleagues,1 of the truly international AQUAMAT group, tested artesunate versus quinine in children who were likely to die from falciparum malaria at 11 centres in sub-Saharan Africa.