Intramuscular arteether to treat severe malaria

People with severe malaria are unconscious, have difficulty breathing, may convulse, and have low blood sugar. They need to be treated quickly, but because of their illness cannot take drugs by mouth. Arteether, an artemisinin derivative, is a possible alternative to the standard drug quinine. There are two types, artemotil and alpha/beta arteether, both are which are given as an intramuscular injection once a day. The authors of this review wanted to compare intramuscular arteether with other drugs used to treat severe malaria. They identified two small trials with 194 participants. Both trials compared arteether with quinine in children with cerebral malaria (an unrousable coma that cannot be attributed to any other cause other than malaria). There was no difference between the drugs in the number of deaths, people with neurological symptoms, or other outcomes, but there were probably too few participants to detect differences.