Multiresistant malaria in Brazil cured with low dose clindamycin
Kremsner, P.G.; Feldmeier, H.; Rocha, R.M.; Graninger, W.
Revista do Instituto de Medicina Tropical de Sao Paulo 30(2): 118-119
1988
ISSN/ISBN: 0036-4665 PMID: 3201061 Document Number: 307883
A 26-year-old man from a non-malarial area in Brazil contracted the disease in Amazonia. He had not previously had malaria. He was treated with amodiaquine (600 mg on day 1 and 450 mg on each of the following 2 days.) Parasitaemia declined from 45 150/ micro l blood on day 1 to 240/ micro l on day 7 (resistance grade II). Oral quinine (as sulfate) was given 500 mg twice daily for 10 days, and at 2 and 3 weeks post treatment the patient was asymptomatic and parasitaemia was zero. 4 weeks after treatment there was a recrudescence of the parasite and quinine was given at the same dosage as before for 3 days together with clindamycin (600 mg twice daily). Symptoms ceased after 2 days but asymptomatic recrudescence occurred 4 weeks later (2088 parasites/ micro l). Oral clindamycin was given alone at 300 mg twice daily for 5 days; parasitaemia cleared 7 days after beginning of treatment and for the next 5 weeks there was no further recrudescence. After the first diagnosis the patient remained in an area where malaria transmission did not occur. The authors conclude that clindamycin is effective against multi drug-resistant P. falciparum.