Abstract
Plasma quinine concentrations were measured in 21 Gambian children with severe falciparum malaria after intramuscular administration of a 20 mg (salt) per kg loading dose of quinine dihydrochloride followed by 10 mg/kg at 12 h intervals. Quinine was well absorbed reaching mean peak concentrations of 15·6 (standard deviation [SD] 4·5) mg/litre in a median time of 3 h (range 1–6 h). A one compartment model was fitted to the plasma concentration-time profile. The mean estimated systemic clearance (C1/F) was 0·89 (SD 0·81) ml/kg/min and the mean elimination half life was 18·8 (SD 8·0) h. Two patients, one of whom died, had low plasma quinine levels which remained below 10 mg/litre. Mean peak and trough plasma concentrations after subsequent intramuscular doses ranged between 11·1 and 15·1 mg/litre. In most cases this dose regimen provided a satisfactory profile of blood concentrations for the treatment of severe malaria in children.
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