Artemisinin derivatives versus quinine for severe malaria in children: a systematic review and meta-analysis.

In contrast, the treatment of severe/complicated childhood malaria appears to be evolving. The 2005 IAP Guideline followed the National Malaria Programme and recommended quinine, suggesting artesunate/artemether as less preferred alternatives(3). In 2008, it was modified as quinine with tetracycline/doxycycline/clindamycin(4) in line with the WHO 2006 statement. The National Guideline 2009(2) suggests artesunate, quinine, artemether, in that order, contraindicating arteether and doxycycline in children. The WHO’s 2010 Guideline(1) strongly recommends aresunate in adults with severe malaria, positioning quinine only as an alternative; however, it cites lack of evidence to frame a similar recommendation for children.