Evaluation of Clindamycin in Combination with Quinine against Multidrug-Resistant Strains of Plasmodium Falciparum

Louis H. MillerMalaria Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20014

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Richard H. GlewMalaria Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20014

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David J. WylerMalaria Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20014

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William A. HowardMalaria Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20014

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William E. CollinsMalaria Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20014

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Peter G. ContacosMalaria Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20014

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Franklin A. NevaMalaria Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20014

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The efficacy of clindamycin, a slow acting antimalarial, in combination with a rapid acting schizonticidal drug, quinine, was determined against three multidrug-resistant strains of Plasmodium falciparum (Cambodian I, Burma [Thau] and Panama II). No recrudescences occurred after treatment with quinine 650 mg orally every 8 hours for 3 days and clindamycin 450 mg orally every 6 hours for 3 days, when administered either simultaneously or sequentially. Quinine alone for 3 days was not curative against infections with these strains. During a 3-day course of therapy, blood levels of quinine or clindamycin were not influenced by administration of the other drug.

Author Notes

Massachusetts General Hospital, Boston, Massachusetts 02114.

Mayo Clinic, Rochester, Minnesota 55901.

Center for Disease Control, Atlanta, Georgia 30333.

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