VI · Treatment · Audience Q3
Severe Falciparum Malaria07 / 18
Why artesunate changed everything.
First-line · Severe malaria
IV Artesunate
2.4 mg/kg at 0 h · 12 h · 24 h — then daily
Do not wait for species confirmation in severe disease.
SEAQUAMAT 2005
34.7%
quinine mortality
AQUAMAT 2010
−22.5%
mortality reduction
WHO 2024
First-line
unequivocal
Advantages over quinine
Rapid parasite clearance — kills all life-cycle stages
Lower mortality — 22.5% RRR (AQUAMAT)
Less hypoglycaemia — no insulin stimulation
Better cerebral outcomes — reduced complications
IV bioavailability in critically ill patients
Oral follow-on — artemether-lumefantrine ACT × 3 d
Examiner trap
Listing quinine as first-line for severe malaria in 2026 costs marks. Quinine is second-line only — when artesunate is unavailable.
CICM Fellowship Masterclass · 2026Dr Timothy Chimunda FCICM
Artesunate07 / 18
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