What is the first-line management for severe falciparum malaria?

The first-line management for severe falciparum malaria is intravenous artesunate. Artesunate is a form of artemisinin, which is a potent antimalarial compound. Its use in severe malaria is preferred due to its rapid action and effectiveness in reducing parasitemia and associated complications.

In severe cases of falciparum malaria, there is an urgent need to reduce the parasite load quickly to prevent life-threatening complications. Intravenous artesunate provides a rapid therapeutic effect and has been shown to improve survival rates in severe malaria compared to some other treatments. It is specifically recommended by the World Health Organization for the treatment of severe cases due to its efficacy and safety profile.

Other options, while they may have applications in different scenarios or forms of malaria, are not the preferred first-line treatments for severe falciparum malaria. Oral artemether and oral quinine, for example, are generally used in non-severe cases or for patients who can tolerate oral medications, while intravenous mefloquine is not commonly used due to its side effects and limited evidence of effectiveness in severe malaria situations.