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Since IVA is not yet widely available as \u201cGood Manufacturing Practices\u201d product, for several years combination treatment with IVA and IVQ was used in some Italian centers to mitigate the legal risks in using an unlicensed drug.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective cohort study was designed to compare IVA\u2009+\u2009IVQ and IVA treatment for imported severe malaria. We collected data from three Italian centers. Adult and pediatric cohorts were analyzed separately.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Forty-nine patients\u00a0treated with IVA and 44\u00a0with IVA\u2009+\u2009IVQ were enrolled, 45 were adults and 48\u00a0children. All acquired malaria in Sub-Saharan Africa. In the adult cohort, median of fever clearance time (FCT) was similar in both groups (48\u00a0h\u00a0vs 48 h, <jats:italic>p<\/jats:italic>\u2009=\u20090.19) but number of patients who reached apyrexia within 48\u00a0h (FCT48) was\u00a0higher in IVA group (20\/24,\u00a083.3%\u00a0vs 8\/17, 47%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). The parasite clearance time (PCT) measure did not differ\u00a0(median 48\u00a0h\u00a0vs 48 h, <jats:italic>p<\/jats:italic>\u2009=\u20090.669). In the pediatric cohort, FCT did not differ\u00a0in the two groups (median 30 vs 48\u00a0h, <jats:italic>p<\/jats:italic>\u2009=\u20090.50) while PCT was longer in IVA\u2009+\u2009IVQ group (median 72 vs 48\u00a0h, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). Adverse events (AEs) in adults were more common in the combination treatment group (6\/19, 31.58% vs 2\/26,\u00a07.69%, <jats:italic>p<\/jats:italic>\u2009=\u20090.055).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>IVA\u2009+\u2009IVQ treatment did not show better outcome\u00a0with respect to IVA monotherapy. AEs were more frequent in the IVA\u2009+\u2009IVQ group compared to the monotherapy. Further studies are necessary to investigate whether IVA\u2009+\u2009IVQ could be an efficient strategy to treat severe malaria cases in areas at high risk of artemisinin resistance.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s15010-022-01771-5","type":"journal-article","created":{"date-parts":[[2022,2,27]],"date-time":"2022-02-27T08:02:16Z","timestamp":1645948936000},"page":"949-958","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Artesunate monotherapy versus artesunate plus quinine combination therapy for treatment of imported severe malaria: a TropNet retrospective cohort study"],"prefix":"10.1007","volume":"50","author":[{"given":"Annarita","family":"Botta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnese","family":"Comelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iacopo","family":"Vellere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia","family":"Chechi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila","family":"Bianchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gardini","family":"Giulia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina Rachele","family":"Tomasoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Spinicci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa","family":"Galli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Castelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Bartoloni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0892-8404","authenticated-orcid":false,"given":"Lorenzo","family":"Zammarchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,2,27]]},"reference":[{"key":"1771_CR1","unstructured":"ECDC. 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