Antiparasitic treatment for severe Plasmodium falciparum malaria.

Antiparasitic treatment for severe imported malaria in metropolitan France uses antimalarial schizonticides, active against Plasmodium falciparum chlo roquine-resistant strains. Quinine, still very efficient, is the basis of t his treatment. Its pharmacokinetic and pharmacodynamic properties have been largely studied. Its neurosensorial and cardiovascular toxicity has been w ell demonstrated. Artemether can be an interesting alternative when confron ted with polychemoresistant strains. Neurotoxicity was demonstrated in anim al models. Antiparasitic treatment is usually quinine IV. There are differe nces in doses, therapeutic protocols, and maximum dosage. There is a contro versy over whether or not to use a loading dose. The treatment surveillance mode is not well defined. Antibiotics and artemether can be used for speci fic indications. (C) 1999 Editions scientifiques et medicales Elsevier SAS.