ABC - antibiotics-based combinations for the treatment of severe malaria?

Almost one million people die of severe malaria every year. In recent years, artemisinin-based combination therapies have become the backbone of the treatment of uncomplicated falciparum malaria and have helped to reduce the burden of malaria in large parts of the malaria-endemic world. However, the treatment of severe malaria, the clinical syndrome responsible for most malaria-associated deaths, remains largely unaffected by this development. Invasive bacterial infections and misdiagnosis of bacterial infections as severe malaria are well recognized phenomena, but recent data indicate that their prevalence and clinical importance might be far greater than previously anticipated. Therefore, there could be good reasons to routinely combine antimalarials, such as artemisinins or quinine, with broad spectrum antibiotics with antimalarial activity in standardized combination therapies for the parenteral treatment of severe falciparum malaria.