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Dose-dependent resorption of quinine after intrarectal administration to children with moderate Plasmodium falciparum malaria.

Author(s): Pussard E, Straczek C, Kabore I, Bicaba A, Balima-Koussoube T, Bouree P, Barennes H

Affiliation(s): Service de Pharmacologie, Hopital de Bicetre, 78 rue du General Leclerc, 94275 Le Kremlin-Bicetre, France. eric.pussard@bct.ap-hop-paris.fr

Publication date & source: 2004-11, Antimicrob Agents Chemother., 48(11):4422-6.

Publication type: Clinical Trial; Comparative Study ; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

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.

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