Intravenous quinine therapy of hospitalized children with Plasmodium falciparum malaria in Kinshasa, Zaire.
To examine the clinical and parasitologic efficacy of quinine, we studied 34 children (7 months-13 years old) with severe or moderately severe Plasmodium falciparum infections. Quinine 10 mg/kg every 8 hr for 3 days was administered, initially by intravenous infusion of quinine formate followed by oral quinine dihydrochloride when tolerated. Thirty-three of the 34 patients were clinically well and had negative malaria smears 7 days after the initiation of therapy; 1 child, who presented in coma, died 29 hr after enrollment. The mean fever clearance time was 44.1 hr, and the mean parasite clearance time was 59.6 hr. A mean peak quinine level of 9.7 ppm was attained after the second dose of quinine, and the minimum concentration was maintained at 5-7 ppm during the 2nd and 3rd hospital days. In vitro testing was conducted with parasites from 10 patients: 9 isolates were resistant to chloroquine, and inhibition of schizont development with quinine occurred at a concentration of 8-32 pmol/well.
Greenberg
A E
AE
Division of Parasitic Diseases, Centers for Disease Control, Atlanta, Georgia.
Nguyen-Dinh
P
P
Davachi
F
F
Yemvula
B
B
Malanda
N
N
Nzeza
M
M
Williams
S B
SB
de Zwart
J F
JF
Nzeza
M
M
D000284:Administration, Oral; D000293:Adolescent; D000818:Animals; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D015023:Democratic Republic of the Congo; D005260:Female; D005334:Fever / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008288:Malaria / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D010963:Plasmodium falciparum / Q000187:drug effects; D011803:Quinine / Q000493:pharmacokinetics / Q000627:therapeutic use*
D011803:Quinine