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We describe an adult with uncomplicated Plasmodium falciparum malaria who did not improve clinically despite 5 days of intramuscular artemether therapy. He was prescribed a lower dose (kg body weight) than that recommended, and a vial from the packet contained only 74% of the artemether dose as stated by the manufacturer. The combination of underdosing, poor-quality drug, and the intrinsic low bioavailability of artemether may have contributed to his poor clinical response. Analysis of the packaging and chemical "fingerprinting" of the artemether suggested that the drug was genuine but was either substandard or had deteriorated after manufacture.

Type

Journal article

Journal

The american journal of tropical medicine and hygiene

Publication Date

04/2008

Volume

78

Pages

552 - 555

Addresses

Adult Infectious Disease Ward, Mahosot Hospital, Vientiane, Lao PDR.

Keywords

Humans, Malaria, Falciparum, Artemisinins, Antimalarials, Treatment Outcome, Drug Therapy, Adult, Laos, Male