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    Am J Trop Med Hyg. 2009 May;80(5):723-8.

    Treatment of severe sepsis with artemether-lumefantrine is associated with decreased mortality in Ugandan patients without malaria.

    Moore CC, Jacob ST, Pinkerton R, Banura P, Meya DB, Reynolds SJ, Kenya-Mugisha N, Mayanja-Kizza H, Scheld WM; Promoting Resource-Limited Interventions for Sepsis Management in Uganda (PRISM-U) Study Group.

    Source

    Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia 22908, USA. ccm5u@virginia.edu

    Abstract

    We enrolled 382 patients at two hospitals in Uganda in a prospective observational study of severe sepsis. Because artemisinins improve survival in murine sepsis models, we performed a post hoc analysis of the association between the use of artemether-lumefantrine (A-L) and mortality in patients with or without malaria. In patients with negative malaria smears (N = 328 of 379), Kaplan-Meier curves revealed decreased combined inpatient and 30-day mortality among patients receiving A-L versus those who did not (20.6%, SE = 10.6 versus 48.8%, SE = 3.2; Log rank chi(2) = 3.93, P = 0.048). The decrease in mortality associated with A-L was maintained in the most clinically ill patients determined by Karnofsky Performance Scores <or= 50 (16.7%, SE = 15.2 versus 58.3%, SE = 3.7; Log rank chi(2) 3.94, P = 0.041). Research into the properties of A-L is needed to improve treatment of sepsis without compromising malarial susceptibility.

    PMID:
    19407113
    [PubMed - indexed for MEDLINE]
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