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Antimicrobial Agents and Chemotherapy, November 2004, p. 4422-4426, Vol. 48, No. 11
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.11.4422-4426.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Dose-Dependent Resorption of Quinine after Intrarectal Administration to Children with Moderate Plasmodium falciparum Malaria

Eric Pussard,1* Celine Straczek,1 Idrissa Kaboré,2 Auguste Bicaba,2 Tatiana Balima-Koussoube,2 Patrice Bouree,1 and Hubert Barennes2

Services de Pharmacologie et de Parasitologie, CHU du Kremlin-Bicêtre, Le Kremlin-Bicêtre, France,1 Unité d'Épidémiologie, Centre Muraz, Bobo Dioulasso, Burkina Faso2

Received 18 February 2004/ Returned for modification 24 May 2004/ Accepted 26 July 2004

The pharmacokinetics of increasing doses of an intrarectal Cinchona alkaloid combination containing 96.1% quinine, 2.5% quinidine, 0.68% cinchonine, and 0.67% cinchonidine (Quinimax) was compared to that of parenteral regimens in 60 children with moderate malaria. Quinine exhibited a nonlinear pharmacokinetics, suggesting a saturation of rectal resorption. When early rejections appeared, blood quinine concentrations decreased by 30 to 50% and were restored by an immediate half-dose administration of the drug. Rectal administration of doses of 16 or 20 mg/kg of body weight led to concentration-time profiles in blood similar to those of parenteral regimens and could be an early treatment of childhood malaria.

* Corresponding author. Mailing address: Service de Pharmacologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France. Phone: 33-1-45-21-35-92. Fax: 33-1-45-21-35-91. E-mail: eric.pussard{at}bct.ap-hop-paris.fr.

Antimicrobial Agents and Chemotherapy, November 2004, p. 4422-4426, Vol. 48, No. 11
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.11.4422-4426.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Barennes, H, Pussard, E (2006). Rectal quinine for malaria: Authors' reply. BMJ 332: 1216-1216 [Full Text]  
  • Barennes, H., Balima-Koussoube, T., Nagot, N., Charpentier, J.-C., Pussard, E. (2006). Safety and efficacy of rectal compared with intramuscular quinine for the early treatment of moderately severe malaria in children: randomised clinical trial.. BMJ 332: 1055-1059 [Abstract] [Full Text]  


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