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Author: Admin | 2025-04-28
Guidelines for Treatment of Malaria in the United States, quinine (in combination with other antimalarial agents) is effective and recommended in the treatment of uncomplicated chloroquine-resistant P. vivax malaria. ContraindicationsHypersensitivity to quinine or any component of the formulation; hypersensitivity to mefloquine or quinidine (cross sensitivity reported); history of potential hypersensitivity reactions (including blackwater fever, immune thrombocytopenia (formerly known as idiopathic thrombocytopenic purpura), thrombotic thrombocytopenic purpura [TTP], hemolytic uremic syndrome [HUS], or thrombocytopenia) associated with prior quinine use; prolonged QT interval; myasthenia gravis; optic neuritis. Dosage and AdministrationDosing: AdultNote: Dosage expressed in terms of the salt; 1 capsule Qualaquin = 324 mg of quinine sulfate = 269 mg of base; Canadian products contain 200 mg of quinine sulfate = 167 mg of base or 300 mg of quinine sulfate = 250 mg of base.Malaria, uncomplicated, due to chloroquine-resistant P. falciparum (treatment): Oral:CDC guidelines: 648 mg every 8 hours, in combination with doxycycline, tetracycline, or clindamycin (preferred in pregnancy). Note: Administer quinine for 3 days unless the infection was acquired in Southeast Asia, in which case quinine duration of therapy is 7 days. Duration of concomitant agent is 7 days, regardless of geographic region (CDC 2013).Canadian product: 600 mg every 8 hours for 3 to 7 days. Note: Use in combination with tetracycline, doxycycline, or clindamycin.Malaria, uncomplicated, due to chloroquine-resistant P. vivax (treatment) (off-label use): Oral: 648 mg every 8 hours, in combination with doxycycline or tetracycline plus primaquine. Note: Quinine in combination with clindamycin is an alternative regimen for pregnant patients. Administer quinine for 3 days unless the infection was acquired in Southeast Asia, in which case quinine duration of therapy is 7 days. Duration of concomitant agent is 7 days (doxycycline, tetracycline, clindamycin) or 14 days (primaquine), regardless of geographic region (CDC 2013).Babesiosis (off-label use): Oral: 650 mg every 6 to 8 hours for at least 7 to 10 days with clindamycin (Vannier 2012; Wormser 2006). Relapsing infection may require at least 6 weeks of therapy (Vannier 2012). Note: US manufactured quinine sulfate capsule is 324 mg; 2 capsules (648 mg quinine sulfate) should be sufficient for adult dosing.Dosing: GeriatricRefer to adult dosing.Dosing: PediatricNote: Dosage expressed in terms of the quinine sulfate salt; 324 mg capsule quinine sulfate = 269 mg of base. Canadian products: 200 mg capsule of quinine sulfate = 167 mg of base or 300 mg capsule of quinine sulfate = 250 mg of base.Malaria: Children and Adolescents; regardless of HIV status (HHS [OI pediatric 2013]): Limited data available in ages Note: Duration of quinine treatment for malaria dependent upon the geographic region or pathogen. Lack of an appropriate quinine dosage form may restrict use in some smaller patients.P. falciparum (chloroquine resistant), uncomplicated; treatment: Oral: 10 mg/kg/dose quinine sulfate every 8 hours for 3 to 7 days depending on region; maximum dose: 650 mg/dose; use in combination with tetracycline, doxycycline, or clindamycin (dependent upon patient age) (CDC 2013)P. vivax (chloroquine resistant), uncomplicated; treatment: Oral: 10 mg/kg/dose quinine sulfate every 8 hours for 3 to 7 days depending
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