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4120710 
Journal Article 
Dexamethasone proves deleterious in cerebral malaria: double blind trial in 100 comatose patients 
Warrell, DA; Looareesuwan, S; Warrell, MJ; Kasemsarn, P; Intaraprasert, R; Et al 
1982 
1 
New England Journal of Medicine
ISSN: 0028-4793
EISSN: 1533-4406 
IPA/82/480132 
Engl 
REF 46 
313-319 
English 
IPA COPYRIGHT: ASHP High dose IV dexamethasone sodium phosphate (Oradexon injection; I) was compared with placebo in a double blind randomized trial involving 100 comatose patients (ages 6-70 yr) with cerebral malaria who were given IV quinine dihydrochloride, starting about 7 hr before the administration of I or placebo. Following diagnosis, II was given every 8 hr over 4 hr in doses of 2 mg/kg (children) and 10 mg/kg (adults). The drug was replaced with quinine sulfate tablets as soon as patients could swallow, and the tablets were taken until one week of therapy was completed. Placebo (sodium chloride solution) or I was given by a slow IV. For children, the dose was 0.6 mg/kg, given immediately and followed by 7 doses of 0.7 mg/kg at 6 hr intervals; for adults, it was 0.5 mg/kg, given immediately and followed by 7 doses of 10 mg each. The total duration of I treatment was 48 hr. Results showed that there were 8 deaths in the I group and 9 in the placebo group. I prolonged coma among the survivors. Complications, including pneumonia and GI bleeding, occurred in 26 patients given I, and 11 given placebo. The results were similar in the subgroup of 28 children (6-14 yr). Results showed that I is deleterious in cerebral malaria and should no longer be used.