title: Clindamycin in combination with chloroquine or quinine is an effective therapy for uncomplicated Plasmodium falciparum malaria in children from Gabon.
abstract: Multidrug resistance of Plasmodium falciparum is becoming common in Africa. In a randomized trial, four short-term regimens were compared for treating uncomplicated P. falciparum malaria in children 4-15 years old in Gabon. One hundred thirty patients received chloroquine (25 mg/kg over 48 h; group C), chloroquine (as above) plus clindamycin (5 mg/kg every 12 h for 6 doses; group CCl), quinine (12 mg/kg every 12 h for 6 doses; group Q), or quinine (as above) plus clindamycin (as above; group QCl). In group C, only 9% of patients were cured by day 28, 44% showed recrudescent malaria (RI), and 47% showed intermediate or high-grade resistance (RII/RIII). In group CCl, 70% of patients were cured and 30% showed recrudescences. In group Q, 32% were cured and 68% showed recrudescences. In group QCl, 88% were cured and 12% showed recrudescences after day 14. All treatment regimens were well tolerated. Thus, the combination of clindamycin with chloroquine or quinine enhances parasite clearance and improves response to therapy.
authors.affiliation: International Research Laboratory, Albert-Schweitzer-Hospital, Lambaréné, Gabon.
authors.forename: P G
authors.initials: PG
authors.lastname: Kremsner
authors.forename: S
authors.initials: S
authors.lastname: Winkler
authors.forename: C
authors.initials: C
authors.lastname: Brandts
authors.forename: S
authors.initials: S
authors.lastname: Neifer
authors.forename: U
authors.initials: U
authors.lastname: Bienzle
authors.forename: W
authors.initials: W
authors.lastname: Graninger
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000008:administration & dosage*; D002981:Clindamycin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005681:Gabon; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D011803:Quinine / Q000008:administration & dosage*
chemical_list: D002981:Clindamycin; D002738:Chloroquine; D011803:Quinine