Low-dose quinine for treatment of Plasmodium falciparum malaria in Guinea-Bissau

The recommended dose of 10 mg quinine/kg bodyweight 3 times a day for 7 day s for treatment of malaria is so high that many patients experience cinchon ism. We have earlier obtained good results with 7 days' treatment with 20 m g Quinimax(TM)/kg bodyweight divided into 2 daily doses. In order to identi fy the lowest effective dose, children with symptomatic malaria were treate d with quinine twice a day for 7 days. They were assigned to 1 of 3 groups treated daily with 10 mg/kg, 15 mg/kg, or 20 mg/kg bodyweight, respectively ; 42, 46, and 34 children, respectively, received treatment and completed 5 weeks of followup. The cumulative percentages of all children with parasit aemia during follow-up on day 28 or before were 33%, 13% and 12%, respectiv ely. Treatment with 10 mg quinine salt/kg daily for 7 days gave a significa ntly higher rate of recrudescence than did treatment with 15 or 20 mg/kg da ily. Thus at least 15 mg of quinine salt/kg bodyweight daily should be reco mmended for treatment of symptomatic plasmodium falciparum malaria in Guine a-Bissau.