Objective: To describe the outcome of 21 successive patients with falciparum malaria treated with artemether-lumefantrine in 6 oral doses of 80-480 mg in 96 hrs (5-day schedule).
Design: Retrospective cohort study.
Method: The data on all successive patients with falciparum malaria that were treated with artemether-lumefantrine in the Leiden University Medical Centre (n = 15) and the Bronovo Hospital (n = 6), the Netherlands, during the period from August 2003 to February 2006 were evaluated.
Results: Ten patients with uncomplicated falciparum malaria were treated exclusively with artemether-lumefantrine; time to parasitological clearance was less than 48 hrs in 5 out of 6 tested patients. The mean admission time was 1.3 days (95% CI: 0.7-1.9). 6 patients with non-severe falciparum malaria were initially treated with intravenous quinine because of vomiting; artemether-lumefantrine was started after an average of 0.9 days. Parasite clearance required more than 48 hrs in all patients. The mean admission time was 3.8 days (95% CI: 2.7-4.9). 5 patients had severe falciparum malaria. They received artemether-lumefantrine 4-24 hrs after starting quinine therapy. The parasite count was < 0.1% after an average of 1.5 days (95% CI: 0.3-2.7). The mean admission time was 4.2 days (95% CI: 2.2-5.2). The serum level of lumefantrine was > or = 500 microg/l (target value) in 9 out of 10 tested patients.
Conclusion: Treatment of falciparum malaria with artemether-lumefantrine according to a 5-day schedule resulted in a swift recovery and short admissions. No relapses were reported.