title: Therapeutic effects of chloroquine in combination with quinine in uncomplicated falciparum malaria.
abstract: The efficacy and toxicity of oral quinine combined with oral chloroquine were studied in 50 Thai men with uncomplicated falciparum malaria. All were treated for 7 days with quinine sulphate (10 mg salt/kg every 8 h). Twenty-five of the patients, selected at random, were also given oral tetracycline (4 mg/kg four times daily) over the same period and the remainder were given chloroquine (25 mg base/kg over the first 3 days). There were no serious adverse effects. Overall fever-clearance times (FCT) and parasite-clearance times (PCT) in the chloroquine and tetracycline groups were not significantly different, with mean (S.D.) values of 51 (33) and 41 (27) h for FCT and 80 (25) and 83 (21) h for PCT, respectively. Most of the patients (18 in each group) were followed for > or = 2 months. Recrudescence rates (R1) were significantly higher in the chloroquine group than in the tetracycline group (39% v. 6%; P = 0.02), all recrudescences occurring within 4 weeks (18-25 days) of starting treatment. Subsequent parasitaemia with Plasmodium vivax, however, occurred less frequently in the chloroquine group (11%) than in the tetracycline group (33%) (P = 0.11) and took longer to develop in the chloroquine group [51 or 59 days compared with a mean (S.D.) value of 29 (10) days in the tetracycline group; P = 0.01]. Within the chloroquine group, FCT and PCT were both shorter in those with cure than in those with R1 resistance, with mean (S.D.) values of 41 (25) and 70 (33) h for FCT (P = 0.09) and 72 (20) and 100 (18) h for PCT (P = 0.01), respectively. Chloroquine does not potentiate the clinical response to quinine against resistant strains of uncomplicated falciparum malaria, nor does it convey any useful antipyretic effect.
authors: Hospital for Tropical Diseases, Faculty of Tropical Medicine, Bangkok, Thailand.
authors: S
authors: S
authors: Vanijanonta
authors: A
authors: A
authors: Chantra
authors: N
authors: N
authors: Phophak
authors: D
authors: D
authors: Chindanond
authors: R
authors: R
authors: Clemens
authors: S
authors: S
authors: Pukrittayakamee
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D002738:Chloroquine / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005334:Fever / Q000188:drug therapy; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D016780:Malaria, Vivax; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000188:drug therapy; D011803:Quinine / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D013752:Tetracycline / Q000009:adverse effects / Q000627:therapeutic use; D013785:Thailand; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials; D002738:Chloroquine; D011803:Quinine; D013752:Tetracycline