From the Guidelines
The recommended dose of artesunate for a 71 kg man with malaria is 2.4 mg/kg given intravenously at 0,12, and 24 hours, then once daily thereafter, as stated in the most recent guidelines 1. For this 71 kg patient, each dose would be approximately 170 mg (71 kg × 2.4 mg/kg). Key points to consider in the treatment of malaria with artesunate include:
- Treatment should continue for at least 24 hours until the patient can tolerate oral medication, at which point a complete course of oral artemisinin-based combination therapy (ACT) should be administered to ensure complete parasite clearance.
- Common ACT options include artemether-lumefantrine, artesunate-amodiaquine, or dihydroartemisinin-piperaquine for 3 days.
- Artesunate works rapidly by targeting the blood stages of all Plasmodium species, particularly P. falciparum, by generating free radicals that damage parasite proteins.
- Monitoring for hemolysis is important, especially 1-3 weeks after treatment, as delayed hemolytic anemia can occur, also known as post-artesunate delayed haemolysis (PADH) 1.
- Adequate hydration, antipyretics, and close monitoring of vital signs, glucose levels, and renal function are also essential during treatment. It's crucial to follow the most recent guidelines for the treatment of malaria, considering the potential for resistance and the importance of effective treatment to prevent morbidity and mortality 1.
From the Research
Dose Calculation of Artesunate for a 71 kg Man with Malaria
To calculate the dose of artesunate for a 71 kg man with malaria, we need to consider the recommended dose per kilogram of body weight.
- The recommended dose of artesunate is 2.4 mg/kg body weight, as stated in the studies 2, 3.
- For a 71 kg man, the dose would be 2.4 mg/kg x 71 kg = 170.4 mg.
Administration of Artesunate
- Artesunate can be administered intravenously, as mentioned in the studies 2, 3, or intra-rectally, as mentioned in the study 4.
- The study 3 suggests that intravenous artesunate should be given as a bolus at 0,12, and 24 hours, and then daily.
Efficacy and Safety of Artesunate
- Artesunate has been shown to be effective in treating severe falciparum malaria, with a lower mortality rate compared to quinine, as stated in the study 3.
- The study 5 suggests that intramuscular artesunate may be superior to intramuscular artemether for the treatment of severe malaria in adults.
- Artesunate is generally well tolerated, with few adverse effects reported, as mentioned in the studies 3, 6, 5.