IN VIVO EFFICACY AND SAFETY OF QUININE-DOXYCYCLINE COMBINATION IN ACUTE PLASMODIUM FALCIPARUM MALARIA

Objective: To find out the in vivo efficacy and adverse effects of quinine doxycycline combination in malaria caused by Plasmodium (R) falciparum. Methodology: It is a prospective, observational study conducted at Department of Medicine, Combined Military Hospital, Quetta, Balochistan, Pakistan, from September 2006 to December 2006. Three hundred thirty seven subjects with positive P.falciparum rings on malaria slide fulfilled the selection criteria and were included in the study. Mean, minimum and maximum values along with standard deviation of age, malarial parasite index fever clearance time and parasite clearance time were calculated. Frequencies of various adverse events and deaths observed during this study were also calculated. Results: Of 337 subjects, 256 had P.falciparum while 81 had mixed infection involving both P.falciparum and P.vivax. Mean fever clearance times in P.falciparum infected subjects and mixed infection were 46.3 hours and 44.16 hours respectively. The mean parasite clearance times in P.falciparum infected subjects and mixed infection were 70.32 hours and 68 hours respectively. About 3.3% of the subjects developed mild to moderate side effects including tinnitus, prolongation of QT interval and vomiting. Mortality rate observed in this study was about 0.6%. Conclusion: Quinine doxycycline combination therapy may be used safety and effectively in the management of P.falciparum malaria.