title: Intravenous quinine therapy of hospitalized children with Plasmodium falciparum malaria in Kinshasa, Zaire.
abstract: 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.
authors.affiliation: Division of Parasitic Diseases, Centers for Disease Control, Atlanta, Georgia.
authors.forename: A E
authors.initials: AE
authors.lastname: Greenberg
authors.forename: P
authors.initials: P
authors.lastname: Nguyen-Dinh
authors.forename: F
authors.initials: F
authors.lastname: Davachi
authors.forename: B
authors.initials: B
authors.lastname: Yemvula
authors.forename: N
authors.initials: N
authors.lastname: Malanda
authors.forename: M
authors.initials: M
authors.lastname: Nzeza
authors.forename: S B
authors.initials: SB
authors.lastname: Williams
authors.forename: J F
authors.initials: JF
authors.lastname: de Zwart
authors.forename: M
authors.initials: M
authors.lastname: Nzeza
mesh_terms: 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*
chemical_list: D011803:Quinine