Intervention Review

Artemisinin derivatives for treating uncomplicated malaria

  1. Heather McIntosh1,*,
  2. Piero Olliaro2

Editorial Group: Cochrane Infectious Diseases Group

Published Online: 26 APR 1999

Assessed as up-to-date: 17 FEB 1999

DOI: 10.1002/14651858.CD000256

How to Cite

McIntosh H, Olliaro P. Artemisinin derivatives for treating uncomplicated malaria. Cochrane Database of Systematic Reviews 1999, Issue 2. Art. No.: CD000256. DOI: 10.1002/14651858.CD000256.

Author Information

  1. 1

    University of Edinburgh, Community Health Sciences General Practice, Edinburgh, UK

  2. 2

    World Health Organization, Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland

*Heather McIntosh, Community Health Sciences General Practice, University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, UK.

Publication History

  1. Publication Status: Stable (no update expected for reasons given in 'What's new')
  2. Published Online: 26 APR 1999




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要


Artemisinin derivatives are a relatively new group of drugs with antimalarial properties. As resistance to other antimalarial drugs continues to increase, artemisinin drugs may be useful alternatives.


The objective of this review was to assess the effects of artemisinin drugs for treating uncomplicated falciparum malaria.

Search methods

We searched the Cochrane Infectious Diseases Group Specialized Register, the Cochrane Controlled Trials Register, MEDLINE, EMBASE, Science Citation Index, LILACS, African Index Medicus, conference abstracts, and reference lists of relevant articles. We contacted organisations, researchers in the field, and drug companies.

Selection criteria

Randomised and quasi-randomised trials of artemisinin derivatives, alone or in combination with other antimalarials, compared with standard antimalarial treatments, in adults or children with uncomplicated falciparum malaria. Only trials where treatment was given by mouth or suppository were included. Comparisons between different artemisinin derivatives and treatment regimens were also included.

Data collection and analysis

Eligibility and trial quality were assessed and data were extracted independently by the two reviewers.

Main results

Forty-one trials involving over 5000 patients were included. Variation in study design and quality made synthesis of the data problematic. Allocation concealment was adequate in only two trials. Most data were from areas of multidrug resistant falciparum malaria in South-East Asia. Compared with standard antimalarial treatments, artemisinin drugs showed fast parasite clearance and high cure rates at follow-up, provided the duration of treatment with artemisinin drugs was adequate. Combination with mefloquine improved sustained parasite clearance and was effective in multidrug resistant areas. When doses were adequate, the combination shortened the duration of treatment. We found no evidence that artemisinin drugs are more harmful than standard treatment drugs over a typical trial period of 28 days.

Authors' conclusions

The evidence suggests that artemisinin drugs are effective and safe for treating uncomplicated malaria. There is no evidence from randomised trials that one artemisinin derivative is better than the others. In areas where there is mefloquine resistance, combination therapy with an artemisinin derivative appears to improve sustained parasite clearance compared with either drug alone.

This review summarizes trials up to 1999. For the reasons in the 'What's new' section, this review will no longer be updated.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要

Artemisinin drugs for treating uncomplicated malaria are better used in combination therapy

Artemisinin drugs come originally from a plant that has been used since ancient times in China as a traditional medicine for fever and malaria. These drugs act quickly and few side effects have been reported. Malaria parasites have so far not developed resistance to artemisinin drugs. The review shows that artemisinin drugs clear malaria parasites from the blood more effectively than standard treatment drugs. In areas where malaria parasites are more resistant to existing drugs, such as South-East Asia, artemisinin drugs are not better at sustained parasite clearance than standard treatment with quinine or mefloquine. Combination treatment using an artemisinin drug together with the longer-acting antimalarial drug mefloquine improves sustained clearance of parasites, but mefloquine is associated with adverse effects. There are few studies on combination treatment with longer-acting antimalarial drugs that are safer than mefloquine. There is no evidence from trials that any of the several artemisinin derivatives is better than the others.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要







我們搜尋了the Cochrane Infectious Diseases Group trials register、the Cochrane Controlled Trials Register、Medline、Embase, Science Citation Index、Lilacs、African Index Medicus;會議摘要及相關溫張的參考文獻。我們和此領域的相關機構、研究者及藥物廠商研究。








目前的證據顯示以artemisinin類藥物治療非複雜性瘧疾是有效且安全的。沒有任何來自隨機對照試驗的證據指出特定一種artemisinin衍生物,比另一種有效。在流行抗mefloquine瘧疾的地區,比起單獨使用其它的藥物,併用artemisinin類藥物似乎可以改善寄生蟲的清除率。本篇回顧將截至1999年的試驗做了整合。由於‘What's new’的關係,本篇回顧將不會再更新。



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要