Clindamycin in Combination with Chloroquine or Quinine Is an Effective Therapy for Uncomplicated Plasmodium falciparum Malaria in Children from Gabon

Abstract

Multidrug resistance of Plasmodium falciparum is becoming common in Africa. In a randomized trial, four short-term regimens were compared for treating uncomplicated P. falciparum malaria in children 4–15 years old in Gabon. One hundred thirty patients received chloroquine (25 mg/kg over 48 h; group C), chloroquine (as above) plus c1indamycin (5 mg/kg every 12 h for 6 doses; group CCI), quinine (12 mg/kg every 12 h for 6 doses; group Q), or quinine (as above) plus c1indamycin (as above; group QCI). In group C, only 9% of patients were cured by day 28, 44% showed recrudescent malaria (RI), and 47% showed intermediate or high-grade resistance (RII/RIII). In group CCI, 70% of patients were cured and 30% showed recrudescences. In group Q, 32% were cured and 68% showed recrudescences. In group QCI, 88% were cured and 12% showed recrudescences after day 14. All treatment regimens were well tolerated. Thus, the combination of c1indamycin with chloroquine or quinine enhances parasite clearance and improves response to therapy.