Volume 49, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



A randomized comparative trial for treating adult patients with malaria was performed in Lambarene, Gabon. Forty-two patients received chloroquine (25 mg/kg for 48 hr) and 38 patients received clindamycin (5 mg/kg twice a day, for five days). Chloroquine treatment cured 15 patients (36%). Twenty patients (48%) showed recrudescent malaria by day 28 of follow-up (RI resistance) and seven patients (17%) showed persistent parasitemia after chloroquine treatment (RII/III resistance). In contrast, clindamycin treatment cured 37 of 38 patients (97%) and only one (3%) showed a recrudescence by day 28 ( < 0.001). Although the parasite clearance time was significantly longer after clindamycin treatment (median five days, range 3–6) than after chloroquine treatment (median four days, range 2–8) ( < 0.01), no differences were seen in the duration of symptoms after chemotherapy. In both treatment groups, no severe side effects occurred. Clindamycin can be used as a safe alternative to achieve radical cure in semi-immune adult patients with chloroquine-resistant malaria in Central Africa.


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