This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ursing, J.
Right arrow Articles by Rombo, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ursing, J.
Right arrow Articles by Rombo, L.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, January 2009, p. 180-185, Vol. 53, No. 1
0066-4804/09/$08.00+0     doi:10.1128/AAC.01111-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Chloroquine Is Grossly Overdosed and Overused but Well Tolerated in Guinea-Bissau{triangledown}

Johan Ursing,1,2* Poul-Erik Kofoed,2,3,4 Amabelia Rodrigues,2 Yngve Bergqvist,5 and Lars Rombo1,6,7

Malaria Research, Department of Infectious Diseases, Karolinska Hospital, Karolinska Institutet, Stockholm,1 Dalarna University College, 781 88 Borlänge,5 Department of Infectious Diseases, Mälarsjukhuset 631 88, Eskilstuna,6 Center for Clinical Research, Sörmland County Council, Eskilstuna, Sörmland, Sweden,7 Projecto de Saúde de Bandim, Indepth Network, Bissau, Guinea-Bissau,2 Department of Paediatrics,3 Research Initiative of Health Services, Kolding Hospital, Kolding, Denmark4

Received 19 August 2008/ Returned for modification 22 September 2008/ Accepted 21 October 2008

High chloroquine doses are commonly prescribed in Guinea-Bissau. Double-dose chloroquine has been shown to be more efficacious (92% efficacy) than the standard dose (80% efficacy). However, chloroquine is toxic when overdosed, and it was not known if the high doses prescribed in Guinea-Bissau were taken or whether they caused adverse effects. We aimed to determine the dosage of chloroquine commonly prescribed, the doses commonly taken, and whether concentration-dependent adverse events occurred in routine practice. Chloroquine prescriptions by eight physicians and chloroquine intake by 102 children were recorded. Chloroquine intake and adverse events were assessed by questioning. Chloroquine concentrations in whole blood were measured. The median total chloroquine dose prescribed and that reportedly taken were 81 and 77 mg kg–1, respectively. The total dose was usually split into two to three daily doses of 6.6 mg kg–1 each. These were taken unsupervised for a median of 5 days. Forty percent of the study children had chloroquine concentrations in the same range as those found in a previous study in which double the normal dose (50 mg kg–1) of chloroquine was taken. Only 3/102 children had Plasmodium falciparum in the blood at the time of diagnosis and treatment. No severe adverse events were reported. No adverse events were associated with higher chloroquine concentrations. High doses of chloroquine are commonly taken and well tolerated in Guinea-Bissau. Malaria diagnostics are poor, and chloroquine is commonly prescribed to children without parasitemia. Use of high-dose chloroquine is concurrent with an exceptionally low prevalence of chloroquine-resistant P. falciparum.

* Corresponding author. Mailing address: Malaria Research, Department of Infectious Diseases, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden. Phone: 46 (0) 70 475 15 30. Fax: 46 (0) 8 51777393. E-mail: johan.ursing{at}ki.se

{triangledown} Published ahead of print on 27 October 2008.

Antimicrobial Agents and Chemotherapy, January 2009, p. 180-185, Vol. 53, No. 1
0066-4804/09/$08.00+0     doi:10.1128/AAC.01111-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»