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Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria
Quinine remains an important anti-malarial drug almost 400 years after its effectiveness was first documented. However, its continued use is challenged by its poor tolerability, poor compliance with complex dosing regimens, and the availability of more efficacious anti-malarial drugs. This article r...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121651/ https://www.ncbi.nlm.nih.gov/pubmed/21609473 http://dx.doi.org/10.1186/1475-2875-10-144 |
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author | Achan, Jane Talisuna, Ambrose O Erhart, Annette Yeka, Adoke Tibenderana, James K Baliraine, Frederick N Rosenthal, Philip J D'Alessandro, Umberto |
author_facet | Achan, Jane Talisuna, Ambrose O Erhart, Annette Yeka, Adoke Tibenderana, James K Baliraine, Frederick N Rosenthal, Philip J D'Alessandro, Umberto |
author_sort | Achan, Jane |
collection | PubMed |
description | Quinine remains an important anti-malarial drug almost 400 years after its effectiveness was first documented. However, its continued use is challenged by its poor tolerability, poor compliance with complex dosing regimens, and the availability of more efficacious anti-malarial drugs. This article reviews the historical role of quinine, considers its current usage and provides insight into its appropriate future use in the treatment of malaria. In light of recent research findings intravenous artesunate should be the first-line drug for severe malaria, with quinine as an alternative. The role of rectal quinine as pre-referral treatment for severe malaria has not been fully explored, but it remains a promising intervention. In pregnancy, quinine continues to play a critical role in the management of malaria, especially in the first trimester, and it will remain a mainstay of treatment until safer alternatives become available. For uncomplicated malaria, artemisinin-based combination therapy (ACT) offers a better option than quinine though the difficulty of maintaining a steady supply of ACT in resource-limited settings renders the rapid withdrawal of quinine for uncomplicated malaria cases risky. The best approach would be to identify solutions to ACT stock-outs, maintain quinine in case of ACT stock-outs, and evaluate strategies for improving quinine treatment outcomes by combining it with antibiotics. In HIV and TB infected populations, concerns about potential interactions between quinine and antiretroviral and anti-tuberculosis drugs exist, and these will need further research and pharmacovigilance. |
format | Online Article Text |
id | pubmed-3121651 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-31216512011-06-24 Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria Achan, Jane Talisuna, Ambrose O Erhart, Annette Yeka, Adoke Tibenderana, James K Baliraine, Frederick N Rosenthal, Philip J D'Alessandro, Umberto Malar J Review Quinine remains an important anti-malarial drug almost 400 years after its effectiveness was first documented. However, its continued use is challenged by its poor tolerability, poor compliance with complex dosing regimens, and the availability of more efficacious anti-malarial drugs. This article reviews the historical role of quinine, considers its current usage and provides insight into its appropriate future use in the treatment of malaria. In light of recent research findings intravenous artesunate should be the first-line drug for severe malaria, with quinine as an alternative. The role of rectal quinine as pre-referral treatment for severe malaria has not been fully explored, but it remains a promising intervention. In pregnancy, quinine continues to play a critical role in the management of malaria, especially in the first trimester, and it will remain a mainstay of treatment until safer alternatives become available. For uncomplicated malaria, artemisinin-based combination therapy (ACT) offers a better option than quinine though the difficulty of maintaining a steady supply of ACT in resource-limited settings renders the rapid withdrawal of quinine for uncomplicated malaria cases risky. The best approach would be to identify solutions to ACT stock-outs, maintain quinine in case of ACT stock-outs, and evaluate strategies for improving quinine treatment outcomes by combining it with antibiotics. In HIV and TB infected populations, concerns about potential interactions between quinine and antiretroviral and anti-tuberculosis drugs exist, and these will need further research and pharmacovigilance. BioMed Central 2011-05-24 /pmc/articles/PMC3121651/ /pubmed/21609473 http://dx.doi.org/10.1186/1475-2875-10-144 Text en Copyright ©2011 Achan et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Achan, Jane Talisuna, Ambrose O Erhart, Annette Yeka, Adoke Tibenderana, James K Baliraine, Frederick N Rosenthal, Philip J D'Alessandro, Umberto Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria |
title | Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria |
title_full | Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria |
title_fullStr | Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria |
title_full_unstemmed | Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria |
title_short | Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria |
title_sort | quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121651/ https://www.ncbi.nlm.nih.gov/pubmed/21609473 http://dx.doi.org/10.1186/1475-2875-10-144 |
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