Controlled trial of 3-day quinine-clindamycin treatment versus 7-day quinine treatment for adult travelers with uncomplicated falciparum malaria imported from the tropics

We conducted a randomized, double-blind, placebo-controlled trial to compar e a 3-day quinine-clindamycin regimen (group QC) with a 7-day quinine regim en (group Q) for the treatment of uncomplicated Plasmodium falciparum malar ia in travelers returning from the tropics. A total of 55 and 53 patients i n groups Q and QC were analyzed, respectively. Adverse effects were similar in both groups, although two patients in group Q had severe adverse reacti ons, leading to the cessation of treatment. The 28-day cure rate for the ev aluated patients (per-protocol analysis) was 100% for group QC, whereas it was 96.3% for group Q (P = 0.5). The 28-day cure rate in the intention-to-t reat analysis was 96.2% for group QC, whereas it was 94.6% for group Q (P = 1). There were no significant differences between the two regimens with re gard to parasite and fever clearance times. Our study shows that the 3-day quinine-clindamycin regimen is well tolerated and compares favorably with a 7-day quinine treatment. This short-term regimen had previously been evalu ated only in areas of endemicity, According to our results, the 3-day quini ne-clindamycin regimen may be an alternative for the treatment of imported uncomplicated P. falciparum malaria in travelers returning from the tropics .