Parenteral therapy of moderately severe malaria: comparison of intramuscular artemether and intramuscular sulfadoxine-pyrimethamine.

We have compared the efficacy of intramuscular artemether against intramuscular sulfadoxine-pyrimethamine in an open randomized study in children with severe but uncomplicated malaria. Parasite clearance time and fever clearance time were faster with artemether. The parasitological clearance on day 14 was 100% for artemether and 98% for sulfadoxine-pyrimethamine, but 8 patients in the artemether group and 1 in the other group had a recrudescence of parasitaemia. There was no toxic reaction of note in either group. We therefore suggest that artemether is a good alternative to the currently used drugs in the parenteral treatment of severe but uncomplicated malaria and may be useful in preventing the possible development of cerebral malaria.