Aim: Our study was compared the efficacy and outcomes in artesunate in relation to quinine therapy in complicated malaria in reference to clinical and biochemical profile in children. Material & methods: A total of 100 patients of complicated malaria due to P. falciparum were selected randomly into 2 groups. Group 1 – was given I.V. Quinine dihydrochloride 20 mg/kg (loading dose) in 10ml of isotonic fluids/kg by infusion over 4hours then 12 hours after the start of loading dose, a maintenance dose of 10mg salt/kg was given I.V. over 4 hours, every 8 hourly, until the patient could swallow, then quinine tab, 10mg/kg 8 hourly to complete 7 day course of treatment. Group 2 – was given I.V. artesunate 2.4 mg/kg dose at 0, 12 and 24 hours, then once a day for total 7 days. Supportive care like antibiotics, antipyretics, anticonvulsants, intravenous fluids, blood transfusion etc were given as and when required. The patients were assessed for:- Fever Clearance Time (FCT) in hours and Coma Resolution Time.
Results: The patients on quinine 50% developed nausea, 24% vomiting, 36% headache, 18% tinnitus, 8% vertigo, 4% hypoglycemia, 4% slurring of speech and 2% circulatory failure. Those patients who were treated with artesunate, only 4% developed nausea and 2% slurring of speech.
Conclusions: There is significant difference between the effectiveness of artesunate therapy and quinine therapy to clinical improvement of malaria children patient i.e artesunate is a better drug in complicated malaria in terms of clinical improvement and tolerability.
