Intravenous ibuprofen (IV-ibuprofen) controls fever effectively in adults with acute uncomplicated Plasmodium falciparum malaria but prolongs parasitemia.

Abstract

Because some febrile patients are unable to swallow or retain oral antipyretic drugs, we carried out a double-blind, placebo-controlled trial in which intravenous ibuprofen (IV-ibuprofen) was given to adults hospitalized with fever associated with acute uncomplicated falciparum malaria treated with oral artesunate plus mefloquine. Thirty patients received IV-ibuprofen 400 mg and 30 received placebo every 6 hours for 72 hours. Reduction in the area above 37.0 degrees C versus time curve was significantly greater for IV-ibuprofen than for placebo during the first 72 hours after first administration. No patients developed severe malaria; parasite clearance was delayed in the patients whose fevers were controlled by IV-ibuprofen (median 37.3 hours versus 23.7 hours in the placebo group [P = 0.0024]). This difference did not appear to be clinically important Adverse events, none considered severe, occurred equally in both groups. IV-ibuprofen was effective and well tolerated in reducing fever in febrile inpatients with malaria.

• Authors: Srivicha Krudsood, Noppadon Tangpukdee, Polrat Wilairatana, Nantaporn Pothipak, Chatnapa Duangdee, David A Warrell, Sornchai Looareesuwan
• Journal: The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 83 Issue 1 Pg. 51-5 (Jul 2010) ISSN: 1476-1645 [Electronic] United States
• PMID: 20595477 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antimalarials
• Artemisinins
• Artesunate
• Mefloquine
• Ibuprofen

Topics

• Acute Disease
• Adult
• Animals
• Antimalarials (therapeutic use)
• Artemisinins (therapeutic use)
• Artesunate
• Double-Blind Method
• Drug Therapy, Combination
• Fever (drug therapy, etiology)
• Humans
• Ibuprofen (therapeutic use)
• Injections, Intravenous
• Malaria, Falciparum (drug therapy, parasitology, physiopathology)
• Mefloquine (therapeutic use)
• Parasitemia (drug therapy, physiopathology)
• Plasmodium falciparum (drug effects)
• Treatment Outcome