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CDC has discontinued its distribution of intravenous artesunate for treatment of severe malaria in the U.S. as of September 30, 2022. Commercial intravenous artesunate, Artesunate for InjectionTM, is available in adequate supply from major drug distributors.
Severe malaria can rapidly progress to death. Having a plan for rapid diagnosis and treatment of malaria within 24 hours ensures that hospitals give patients with malaria the best chance of recovery.
- Testing for malaria and obtaining results within hours of a patient’s presentation is the first step towards timely treatment. If on-site malaria diagnosis is not available, other options could include having a plan for diagnostics to be performed by a facility nearby, or transfer of the patient to a facility with diagnostic capacity.
- Options for timely treatment of malaria include:
- Stocking intravenous artesunate. This allows for immediate treatment of severe malaria once diagnosed and provides patients with the best chance of a good outcome.
- Having a plan in place for emergency procurement. Hospitals that do not stock intravenous artesunate may request an emergency procurement, but should be aware that emergency procurement from distributors may take 24 hours or more.
- Transferring patients diagnosed with severe malaria to a facility with intravenous artesunate in stock is another option but may result in delayed treatment.
- Stocking artemether-lumefantrine (Coartem®), a fast acting oral antimalarial, will facilitate immediate interim treatment while procuring intravenous artesunate. Second-line options include atovaquone-proguanil and quinine. The only option for interim treatment in pregnant women in their first trimester or infants <5 kg is quinine.
- An added benefit to stocking artemether-lumefantrine is that it is the first-line drug in the United States for uncomplicated P. falciparum malaria. For women in their first trimester of pregnancy and infants <5 kgs, the first-line treatment for uncomplicated P. falciparum malaria is quinine plus clindamycin.
Information on where to purchase Artesunate for InjectionTM can be found here (Amivas: Artesunate for Injection) or by calling 1-855-5AMIVAS.
Information on treatment of severe malaria can be found here.
Information on treatment of uncomplicated malaria can be found here.
CDC will continue to support the appropriate diagnosis and treatment of malaria in the United States through its ongoing 24/7/365 activities, such as providing guidance and education on malaria.
Créditos: Comité científico Covid