Publication: Quinine-tetracycline for multidrug resistant falciparum malaria
Issued Date
1996-03-01
Resource Type
ISSN
01251562
Other identifier(s)
2-s2.0-0030091059
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Southeast Asian Journal of Tropical Medicine and Public Health. Vol.27, No.1 (1996), 15-18
Suggested Citation
Danai Bunnag, Juntra Karbwang, Kesara Na-Bangchang, Aurathai Thanavibul, Sunee Chittamas, Tranakchit Harinasuta Quinine-tetracycline for multidrug resistant falciparum malaria. Southeast Asian Journal of Tropical Medicine and Public Health. Vol.27, No.1 (1996), 15-18. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/17757
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Title
Quinine-tetracycline for multidrug resistant falciparum malaria
Abstract
Plasmodium falciparum in Southeast Asia is highly resistant to chloroquine and sulfadoxine/ pyrimethamine. Quinine-tetracycline has been used as a second line treatment for uncomplicated falciparum malaria, but duration of treatment varies from place to place. The 7-days course of this combination has been shown to be very effective. However, due to the cinchonism adverse effects, the patient compliance has not been satisfactory. We have evaluated the efficacy of a 7-days course of tetracycline in combination with either 5 or 7-days course of quinine. Ninety male Thai patients who were admitted to the Bangkok Hospital for Tropical Diseases were randomized to receive tetracycline 250 mg qid for 7 days in combination with either quinine 600 mg tid for 5 days (Q5T7; group A) or quinine 600 mg tid for 7 days (Q7T7; group B). The patients were hospitalized for 28 days. Patients in both groups had a comparable initial response to treatment, with the clearance of fever and parasites within 4 days. There were 46 and 40 patients in group A and B, respectively, who completed the 28 day of follow-up. The cure rates were 87 and 100%, respectively for group A and B. No serious adverse effects were found in either group; transient nausea, vomiting and tinnitus were common findings. The incidence of adverse effects was not different between the two groups. The results from the present study suggest that a short course treatment of quinine (Q5T7) had significantly decreased the cure rate. In areas with quinine resistant falciparum malaria, a full course of 7-days quinine, in combination with 7-days course of tetracycline is recommended for hospital treatment. However, an alternative shorter course of antimalarials is suggested for home treatment.