INTRARECTAL QUINIMAX(R) (A COMBINATION OF CINCHONA ALKALOIDS) ADMINISTERED AT 3 DIFFERENT DOSAGES TO CHILDREN WITH PLASMODIUM-FALCIPARUM MALARIA IN NIGER

In order to optimise the intrarectal administration of Quinimax(R). th is combination of Cinchona alkaloids uas administered intrarectally at 3 different dosages to 13 children with acute uncomplicated Plasmodiu m, falciparum, malaria in Niger. Four children received 8 mg/kg and 5 received 13 mg/kg every 8 hours for 3 days. A further 4 children recei ved 20 mg/kg every 12 hours for 3 days. The clinical and parasitologic al status of the children was similar in the 3 groups at admission. Te mperature fell stably to normal at 36 hours with all 3 regimens. Total clearance of parasitaemia was only obtained at 48; hours with the 20 mg/kg regimen. All the patients were aparasitaemic by day 7. Whole blo od quinine concentrations increased linearly with the 3 doses, Even th ough the 20 mg/kg 12-hourly regimen led to the highest peal; concentra tions of quinine, trough concentrations were lower than those obtained with the other 2 regimens. Pharmacokinetic simulation allowed us to p ropose that intrarectal administration of Quinimax(R) 20 mg/kg every 8 hours will lead to effective and nontoxic quinine concentrations.