Efficacy of a 3-day oral regimen of a quinine-quinidine-cinchonine association (Quinimax) for treatment of falciparum malaria in Madagascar.
In the search for an effective, safe and field-adapted alternative to chloroquine for therapy of chloroquine-resistant Plasmodium falciparum infections in Africa, a 3-d oral regimen of Quinimax (an association of quinine, quinidine and cinchonine) was evaluated in 35 individuals with P. falciparum in Madagascar, an area with chloroquine resistance. 63% of the parasite strains isolated were resistant in vitro to chloroquine, and 59% of the infections were present despite previous chloroquine intake. Three daily oral doses of 10 mg/kg Quinimax for 3 d cleared parasitaemia and improved clinical status in all subjects. Mean parasite and fever clearance times were 51.7 and 37.4 h, respectively. All patients were aparasitaemic at the end of the 7-d follow-up. When formulating therapy guidelines, the 3-d Quinimax regimen should be considered as a valuable alternative to chloroquine for treating falciparum malaria in African areas with clinical resistance to chloroquine.
Deloron
P
P
Institut National de la Santé et da le Recherche Médicale (INSERM), Hôpital Claude Bernard, Paris, France.
Lepers
J P
JP
Verdier
F
F
Chougnet
C
C
Remanamirija
J A
JA
Andriamangatiana-Rason
M D
MD
Coulanges
P
P
Jaureguiberry
G
G
D000818:Animals; D002738:Chloroquine / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008270:Madagascar; D008288:Malaria / Q000188:drug therapy*; D008297:Male; D010963:Plasmodium falciparum / Q000187:drug effects / Q000302:isolation & purification; D011803:Quinine / Q000008:administration & dosage / Q000627:therapeutic use*
D004338:Drug Combinations; D002738:Chloroquine; D011803:Quinine