Adults and children with severe malaria (including infants, pregnant women in all trimesters and lactating women) should be treated with intravenous or intramuscular artesunate for at least 24 h and until they can tolerate oral medication. Once a patient has received at least 24 h of parenteral therapy and can tolerate oral therapy, treatment should be completed with 3 days of an artemisinin-based combination therapy (ACT).