MARCHOU B, SAILLER L, ALVAREZ M, LAVIT M, HOUIN G, MASSIP P; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 729 (abstract no. 1852).
Hosp. Purpan, Toulouse, FRANCE.
BACKGROUND: The recommended dosage of Q for severe and/or SE Asia acquired Pf malaria is 24 mg Q-base/kg/d so as to achieve plasma Q levels between 8 and 15 mg/l. In our experience over the last 2 decennies a 16 mg/kg/d dose of Q-base regimen was effective to treat African uncomplicated Pf malaria (95% of cases imported in France). The objective was to assess the pharmacokinetics and efficacy of a 16 mg Q-base/kg/d regimen to treat Africa uncomplicated malaria cases. Patients/METHODS: Inclusion criteria were: Pf confirmed malaria (QBC+smear); no WHO criteria of severity; no previous treatment by Q; nausea or vomiting contra-indicating oral initial therapy. Quinimax [TM] (Q[TM]) used in this study contains 100% of alcaloid base of which 96% is Q. The pts received 8 mg/kg of Q[TM] via 4-hour IV infusions at H0, H12, H24, H36, then the same daily dosage orally for a total (IV+PO) of 5 to 7 days. Plasma Q levels were determined by HPLC at H4, H12, H24, H48. Parasitemia was controlled at H48.RESULTS: 26 pts (M/ F: 14/ 12; mean age: 34.6 yr) were included, 18 returned from West and 8 from Central Africa. Chemoprophylaxis was absent in 17 and inadequate in 6 cases. The mean delay for diagnosis was 4.1 days (1-15). The mean baseline values were: hemoglobin: 12.3 ( SD:2.0) g/dl, platelets: 91 ( SD:48) giga/l, parasitemia: 0.8% (ext: 0.01-3.5; SD: 0.7). Mean (SD) Q levels (mg/l) were respectively at H4, H12, H24 and H48: 7.60 (3.02), 6.40 (1.71), 8,17 (2.90) and 9.00 (3.10). The mean delay of apyrexia was 32.8 hours ( SD:21.6). At H48 the mean parasitemia was 0.012% (ext: 0-0.01; SD:0.027). No relapse were recorded.CONCLUSION: This study confirms the efficacy of a 16mg/kg/d regimen of Q-base for uncomplicated African malaria, with Q plasma levels ranging from 5 to 10 mg/l.
Publication Types:
Keywords:
- Africa
- Africa, Central
- Animals
- Antigens, Protozoan
- Asia
- Cinchona
- Cinchona Alkaloids
- France
- Humans
- Malaria
- Malaria Vaccines
- Parasitemia
- Plasmodium falciparum
- Quinine
- Recurrence
- Weights and Measures
- immunology
Other ID:
UI: 102246506
From Meeting Abstracts