A controlled clinical trial of artemether (qinghaosu derivative) versus quinine in complicated and severe falciparum malaria.

31 pairs of patients with complicated falciparum malaria (with anaemia, jaundice, raised blood urea, hyperpyrexia or more than 2% of erythrocytes parasitized) were treated with artemether or quinine. All patients in the artemether group survived but 2 of those treated with quinine died. Fever clearance time and parasite clearance time of patients treated with artemether were significantly shorter than in the quinine-treated group. One patient who failed to respond to quinine within 72 h was saved with artemether. Follow-up of the patients showed that 9 of 23 (39.1%) recrudesced on day 28 in the artemether group. In the quinine group the recrudescence rate was 9% (2 of 22). Hence artemether may be considered as one of the drugs of choice for severely ill patients; it may even be better than quinine.