CURING OF CHLOROQUINE-RESISTANT MALARIA WITH CLINDAMYCIN

A randomized comparative trial for treating adult patients with Plasmo dium falciparum malaria was performed in Lambarene, Gabon. Forty-two p atients received chloroquine (25 mg/kg for 48 hr) and 38 patients rece ived clindamycin (5 mg/kg twice a day, for five days). Chloroquine tre atment cured 15 patients (36%). Twenty patients (48%) showed recrudesc ent malaria by day 28 of follow-up (RI resistance) and seven patients (17%) showed persistent parasitemia after chloroquine treatment (RII/I II resistance). In contrast, clindamycin treatment cured 37 of 38 pati ents (97%) and only one (3%) showed a recrudescence by day 28 (P < 0.0 01). Although the parasite clearance time was significantly longer aft er clindamycin treatment (median five days, range 3-6) than after chlo roquine treatment (median four days, range 2-8) (P < 0.01), no differe nces were seen in the duration of symptoms after chemotherapy. In both treatment groups, no severe side effects occurred. Clindamycin can be used as a safe alternative to achieve radical cure in semi-immune adu lt patients with chloroquine-resistant P. falciparum malaria in Centra l Africa.