Pengsaa, KrisanaSirivichayakul, ChukiatNa-Bangchang, KesaraThaiarporn, ItthiponChaivisuth, AnongWongsuwan, AmnajAttanath, PhanorsriPojjaroen-Anant, ChanathepWisetsing, PatarapornChanthavanich, PornthepSabchareon, Arunee2009-05-272009-05-272005-05-30Pengsaa K, Sirivichayakul C, Na-Bangchang K, Thaiarporn I, Chaivisuth A, Wongsuwan A, Attanath P, Pojjaroen-Anant C, Wisetsing P, Chanthavanich P, Sabchareon A. Life-saving rectal artesunate for complicated malaria in children. The Southeast Asian Journal of Tropical Medicine and Public Health. 2005 May; 36(3): 597-601http://imsear.searo.who.int/handle/123456789/30799The Southeast Asian Journal of Tropical Medicine and Public Health.We report the effectiveness of two regimens of rectal artesunate formulation in treating 13 Thai children with cerebral/complicated falciparum malaria. The drug was given at an initial dose of 40 mg/kg bodyweight, in 3 or 4 divided doses in the first 24 hours, followed by 10 mg/kg bodyweight once daily for three consecutive days. Mefloquine, at a dose of 15 mg/kg bodyweight was given orally at 72 hours after the initial dose of artesunate, followed by 10 mg/kg bodyweight 6 hours later. Three cases with cerebral malaria gained consciousness within 20 hours of artesunate administration. The median time required for reduction of parasitemia by 90% of the initial value (P90) in 13 children was 11.2 hours. No recrudescence was observed in any of the patients during the 28-day follow-up period. Plasma concentrations of artesunate and dihydroartemisinin (active plasma metabolite of artesunate) measured in two patients who received the high initial dose regimen (20 mg/ kg bodyweight) suggested rapid absorption and adequate plasma concentrations of both compounds following the administration of artesunate via the rectal route. Further studies for the optimized regimen of rectal artesunate in the treatment of cerebral/complicated childhood falciparum malaria in areas of multidrug resistance are warranted.engAdministration, RectalAnimalsAntimalarials --administration & dosageArtemisinins --administration & dosageChildChild WelfareChild, PreschoolDrug Resistance, MultipleDrug Therapy, CombinationHumansMalaria, Cerebral --drug therapyMalaria, Falciparum --drug therapyMefloquine --administration & dosagePlasmodium falciparum --drug effectsSesquiterpenes --administration & dosageSuppositoriesThailandTreatment OutcomeJournal Article