Publication: Therapeutic responses to quinine and clindamycin in multidrug-resistant falciparum malaria
Issued Date
2000-09-06
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ISSN
00664804
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2-s2.0-0033840511
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Mahidol University
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SCOPUS
Bibliographic Citation
Antimicrobial Agents and Chemotherapy. Vol.44, No.9 (2000), 2395-2398
Suggested Citation
S. Pukrittayakamee, A. Chantra, S. Vanijanonta, R. Clemens, S. Looareesuwan, N. J. White Therapeutic responses to quinine and clindamycin in multidrug-resistant falciparum malaria. Antimicrobial Agents and Chemotherapy. Vol.44, No.9 (2000), 2395-2398. doi:10.1128/AAC.44.9.2395-2398.2000 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/26169
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Title
Therapeutic responses to quinine and clindamycin in multidrug-resistant falciparum malaria
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Abstract
Therapeutic responses to clindamycin in combination with quinine were assessed in adult Thai patients with uncomplicated multidrug-resistant Plasmodium falciparum malaria. In total 204 patients were randomized to receive a 7-day oral treatment regimen of quinine (Q7) either alone (n = 68), in combination with clindamycin (Q7C7; n = 68), or in combination with tetracycline (Q7T7; n = 68). All patients had uncomplicated recoveries with no serious adverse effects. Fever clearance times for both of the two combination regimens (median of 47 h and range of 8 to 120 h for Q7C7 and median of 36 h and range of 8 to 117 h for Q7T7) were significantly shorter than that for the Q7-only regimen (median, 56; range, 4 to 152 h) (P = 0.002). Parasite clearance times (overall mean ± standard deviation, 78 ± 23 h) were not significantly different between the three treatment groups (P = 0.98). The cure rates assessed at 28 days of follow-up were 100% for Q7C7 and 98% for Q7T7, whereas the cure rate was 87% for the Q7-only regimen (P ≤ 0.04). Clindamycin in combination with quinine is a safe and effective treatment for multidrug-resistant P. falciparum malaria. This combination may be of particular value in children and pregnant women, in whom tetracyclines are contraindicated.