Efficacy of proveblue (methylene blue) in an experimental cerebral malaria murine model. Antimicrob

Although 100 % of untreated mice infected with Plasmodium berghei died with specific signs of cerebral malaria and 100 % of mice treated with 3 mg/kg dihydroartemisinin, the active metabolite of artesunate, which is used as the first-line treatment for severe malaria, also died but showed no specific signs of cerebral malaria, 78 % of mice treated with 10 mg/kg Proveblue (methyl-ene blue) and 78 % of mice treated with a combination of 3 mg dihydroartemisinin and 10mg/kg Proveblue survived and showed no specific signs of cerebral malaria or detectable parasites. In 2002, the World Health Organization (WHO) recommendedthat artemisinin-based combination therapy (ACT) should be used for all cases of uncomplicated malaria. Four years later, the WHO added the recommendation that artesunate should be de-ployed as the first-line treatment for severe malaria in adults and should replace quinine due to its efficacy and better tolerance (1). In 2010, a large-scale trial confirmed artesunate potency in the treatment of severe malaria in children (2). In 2011, the WHO recommended artesunate as the first-line treatment for severema-laria. In recent years, several studies have reported clinical failures or at least extended parasite clearance times in Cambodia (3–5)