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1.
Jelinek T, Schulte C, Behrens R, Grobusch MP, Coulaud JP, Bisoffi Z, Matteelli A, Clerinx J, Corachán M, Puente S, Gjørup I, Harms G, Kollaritsch H, Kotlowski A, Björkmann A, Delmont JP, Knobloch J, Nielsen LN, Cuadros J, Hatz C, Beran J, Schmid ML, Schulze M, Lopez-Velez R, Fleischer K, Kapaun A, McWhinney P, Kern P, Atougia J, Fry G, da Cunha S, Boecken G, 2002. Imported falciparum malaria in Europe: sentinel surveillance data from the European network on surveillance of imported infectious diseases. Clin Infect Dis 34: 572–576.
-
2.
Boccolini D, Romi R, D'Amato S, Pompa MG, Majori G, 2007. Sorveglianza della malaria in Italia e analisi della casistica del quinquennio 2002–2006. Giornale Italiano di Medicina Tropicale 12: 5–12.
-
3.
Dondorp A, Nosten F, Stepniewska K, Day N, White N, 2005. South East Asian Quinine Artesunate Malaria Trial (SEAQUAMAT) group. Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial. Lancet 366: 717–725.
-
4.
World Health Organization, 2010. Guidelines for the treatment of malaria, second edition. Available at: http://www.who.int/malaria/publications/atoz/9789241547925/en/index/html. Accessed May 8, 2010.
-
5.
Jones KL, Donegan S, Lalloo DG, 2007. Artesunate versus quinine for treating severe malaria. Cochrane Database Syst Rev 4: CD005967.
-
6.
Jelinek T, 2005. Intravenous artesunate recommended for patients with severe malaria: position statement from TropNetEurop. Euro Surveill 10: E0511245.
-
7.
Lalloo DG, Shingadia D, Pasvol G, Chiodini PL, Whitty CJ, Beeching NJ, Hill DR, Warrell DA, Bannister BA, 2007. HPA Advisory Committee on Malaria Prevention in UK Travelers. UK malaria treatment guidelines. J Infect 54: 111–121.
-
8.
Rosenthal PJ, 2008. Artesunate for the treatment of severe falciparum malaria. N Engl J Med 358: 1829–1836.
-
9.
Mørch K, Strand Ø, Dunlop O, Berg A, Langeland N, Leiva RA, Longva JA, Sjursen H, Skrede S, Sundal J, Jensenius M, 2008. Severe malaria and artesunate treatment, Norway. Emerg Infect Dis 14: 1816–1818.
-
10.
Studdert DM, Mello MM, Sage WM, DesRoches CM, Peugh J, Zapert K, Brennan TA, 2005. Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. J Am Med Assoc 293: 2609–2617.
-
11.
Newton PN, Chierakul W, Ruangveerayuth R, Silamut K, Teerapong P, Krudsood S, Looareesuwan S, White NJ, 2001. A comparison of artesunate alone with combined artesunate and quinine in the parenteral treatment of acute falciparum malaria. Trans R Soc Trop Med Hyg 95: 519–523.
-
12.
Zamidei L, Durval A, Bettocchi D, Luzzio MG, Bartoloni A, Consales G, 2010. Efficacy and safety of quinine-artesunate in an HIV-positive patient with severe falciparum malaria. Minerva Anestesiol 76: 66–69.
-
13.
Mascarello M, Allegranzi B, Angheben A, Anselmi M, Concia E, Laganà S, Manzoli L, Marocco S, Monteiro G, Bisoffi Z, 2008. Imported malaria in adults and children: epidemiological and clinical characteristics of 380 consecutive cases observed in Verona, Italy. J Travel Med 15: 229–236.
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| Abstract Views | 22 | 22 | 2 |
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Combined Intravenous Treatment with Artesunate and Quinine for Severe Malaria in Italy
Alessandro Bartoloni
Alessandro Bartoloni
Clinica Malattie Infettive, Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze, Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy; Dipartimento di Pediatria, Università di Firenze, Firenze, Italy; UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy
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Lina Tomasoni
Lina Tomasoni
Clinica Malattie Infettive, Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze, Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy; Dipartimento di Pediatria, Università di Firenze, Firenze, Italy; UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy
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Filippo Bartalesi
Filippo Bartalesi
Clinica Malattie Infettive, Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze, Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy; Dipartimento di Pediatria, Università di Firenze, Firenze, Italy; UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy
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Luisa Galli
Luisa Galli
Clinica Malattie Infettive, Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze, Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy; Dipartimento di Pediatria, Università di Firenze, Firenze, Italy; UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy
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Spartaco Sani
Spartaco Sani
Clinica Malattie Infettive, Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze, Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy; Dipartimento di Pediatria, Università di Firenze, Firenze, Italy; UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy
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Sara Veloci
Sara Veloci
Clinica Malattie Infettive, Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze, Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy; Dipartimento di Pediatria, Università di Firenze, Firenze, Italy; UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy
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Lorenzo Zammarchi
Lorenzo Zammarchi
Clinica Malattie Infettive, Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze, Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy; Dipartimento di Pediatria, Università di Firenze, Firenze, Italy; UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy
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Alessandro Pini
Alessandro Pini
Clinica Malattie Infettive, Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze, Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy; Dipartimento di Pediatria, Università di Firenze, Firenze, Italy; UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy
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Francesco Castelli
Francesco Castelli
Clinica Malattie Infettive, Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze, Firenze, Italy; SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy; Dipartimento di Pediatria, Università di Firenze, Firenze, Italy; UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy
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Severe imported malaria is an important problem in European countries, where approximately 8,000 cases of Plasmodium falciparum malaria are reported each year. Although the World Health Organization recommends intravenous artesunate (IVA) as the treatment of choice for severe malaria in areas of low transmission, it is rarely used in Europe, because it is not yet available as a drug manufactured under Good Manufacturing Practices. We report a series of eight imported severe falciparum malaria cases treated with IVA combined with intravenous quinine (IVQ). This combined therapy was found to be efficacious, safe, and well-tolerated. The only observed death occurred in a young man who presented 10 days after the onset of symptoms. IVA plus IVQ treatment seems to be an acceptable approach, because the legal risks in using an unlicensed drug for treating a severe malaria case denies the patient the possibility of being treated with the most effective regimen.
Author Notes
Authors' addresses: Alessandro Bartoloni, Sara Veloci, and Lorenzo Zammarchi, Clinica Malattie Infettive, Università di Firenze Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy, E-mails: bartoloni@unifi.it, sara.veloci@gmail.com, and lorenzozammarchi@hotmail.it. Lina Tomasoni, Alessandro Pini, and Francesco Castelli, Istituto Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy, E-mails: l.tomasoni@infettivibrescia.it, alessandropini79@yahoo.it, and castelli@med.unibs.it. Filippo Bartalesi, SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy, E-mail: bartalesif@aou-careggi.toscana.it. Luisa Galli, Dipartimento di Pediatria, Università degli Studi di Firenze, Firenze, Italy, E-mail: luisa.galli@unifi.it. Spartaco Sani, UO Malattie Infettive, Spedali Riuniti Livorno, Livorno, Italy, E-mail: spartacosani@virgilio.it.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
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-
1.
Jelinek T, Schulte C, Behrens R, Grobusch MP, Coulaud JP, Bisoffi Z, Matteelli A, Clerinx J, Corachán M, Puente S, Gjørup I, Harms G, Kollaritsch H, Kotlowski A, Björkmann A, Delmont JP, Knobloch J, Nielsen LN, Cuadros J, Hatz C, Beran J, Schmid ML, Schulze M, Lopez-Velez R, Fleischer K, Kapaun A, McWhinney P, Kern P, Atougia J, Fry G, da Cunha S, Boecken G, 2002. Imported falciparum malaria in Europe: sentinel surveillance data from the European network on surveillance of imported infectious diseases. Clin Infect Dis 34: 572–576.
-
2.
Boccolini D, Romi R, D'Amato S, Pompa MG, Majori G, 2007. Sorveglianza della malaria in Italia e analisi della casistica del quinquennio 2002–2006. Giornale Italiano di Medicina Tropicale 12: 5–12.
-
3.
Dondorp A, Nosten F, Stepniewska K, Day N, White N, 2005. South East Asian Quinine Artesunate Malaria Trial (SEAQUAMAT) group. Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial. Lancet 366: 717–725.
-
4.
World Health Organization, 2010. Guidelines for the treatment of malaria, second edition. Available at: http://www.who.int/malaria/publications/atoz/9789241547925/en/index/html. Accessed May 8, 2010.
-
5.
Jones KL, Donegan S, Lalloo DG, 2007. Artesunate versus quinine for treating severe malaria. Cochrane Database Syst Rev 4: CD005967.
-
6.
Jelinek T, 2005. Intravenous artesunate recommended for patients with severe malaria: position statement from TropNetEurop. Euro Surveill 10: E0511245.
-
7.
Lalloo DG, Shingadia D, Pasvol G, Chiodini PL, Whitty CJ, Beeching NJ, Hill DR, Warrell DA, Bannister BA, 2007. HPA Advisory Committee on Malaria Prevention in UK Travelers. UK malaria treatment guidelines. J Infect 54: 111–121.
-
8.
Rosenthal PJ, 2008. Artesunate for the treatment of severe falciparum malaria. N Engl J Med 358: 1829–1836.
-
9.
Mørch K, Strand Ø, Dunlop O, Berg A, Langeland N, Leiva RA, Longva JA, Sjursen H, Skrede S, Sundal J, Jensenius M, 2008. Severe malaria and artesunate treatment, Norway. Emerg Infect Dis 14: 1816–1818.
-
10.
Studdert DM, Mello MM, Sage WM, DesRoches CM, Peugh J, Zapert K, Brennan TA, 2005. Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. J Am Med Assoc 293: 2609–2617.
-
11.
Newton PN, Chierakul W, Ruangveerayuth R, Silamut K, Teerapong P, Krudsood S, Looareesuwan S, White NJ, 2001. A comparison of artesunate alone with combined artesunate and quinine in the parenteral treatment of acute falciparum malaria. Trans R Soc Trop Med Hyg 95: 519–523.
-
12.
Zamidei L, Durval A, Bettocchi D, Luzzio MG, Bartoloni A, Consales G, 2010. Efficacy and safety of quinine-artesunate in an HIV-positive patient with severe falciparum malaria. Minerva Anestesiol 76: 66–69.
-
13.
Mascarello M, Allegranzi B, Angheben A, Anselmi M, Concia E, Laganà S, Manzoli L, Marocco S, Monteiro G, Bisoffi Z, 2008. Imported malaria in adults and children: epidemiological and clinical characteristics of 380 consecutive cases observed in Verona, Italy. J Travel Med 15: 229–236.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 22 | 22 | 2 |
| Full Text Views | 351 | 96 | 1 |
| PDF Downloads | 105 | 33 | 0 |