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In some areas clinicians have combined parenteral artesunate and quinine in the belief that the 2 drugs would be additive or synergistic in severe malaria. A randomized comparison of the effectiveness of intravenous (i.v.) artesunate versus i.v. artesunate and i.v. quinine together on parasite clearance was conducted in 1998/99 amongst 69 patients with uncomplicated and severe Plasmodium falciparum malaria in western Thailand. The parasite clearance time did not differ significantly between the 2 treatment groups (P = 0.12), but adverse events were significantly more frequent in the artesunate plus quinine group (P = 0.05). Quinine did not have a significant antipyretic effect and artesunate did not affect the electrocardiographic QTc interval. There is no benefit evident from combining parenteral administration of these 2 antimalarial drugs in the acute phase of treatment.

Original publication




Journal article


Trans R Soc Trop Med Hyg

Publication Date





519 - 523


Acute Disease, Adolescent, Adult, Aged, Antimalarials, Artemisinins, Artesunate, Drug Synergism, Drug Therapy, Combination, Echocardiography, Female, Heart Rate, Humans, Infusions, Intravenous, Malaria, Falciparum, Male, Middle Aged, Quinine, Sesquiterpenes