Intrarectal Quinimax(R) (a combination of cinchona alkaloids) administered at 3 different dosages to children with Plasmodium falciparum malaria in Niger

In order to optimise the intrarectal administration of Quinimax(R). this combination of Cinchona alkaloids uas administered intrarectally at 3 different dosages to 13 children with acute uncomplicated Plasmodium, falciparum, malaria in Niger. Four children received 8 mg/kg and 5 received 13 mg/kg every 8 hours for 3 days. A further 4 children received 20 mg/kg every 12 hours for 3 days. The clinical and parasitological status of the children was similar in the 3 groups at admission. Temperature fell stably to normal at 36 hours with all 3 regimens. Total clearance of parasitaemia was only obtained at 48; hours with the 20 mg/kg regimen. All the patients were aparasitaemic by day 7. Whole blood quinine concentrations increased linearly with the 3 doses, Even though the 20 mg/kg 12-hourly regimen led to the highest peal; concentrations of quinine, trough concentrations were lower than those obtained with the other 2 regimens. Pharmacokinetic simulation allowed us to propose that intrarectal administration of Quinimax(R) 20 mg/kg every 8 hours will lead to effective and nontoxic quinine concentrations.