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Ineffectiveness of Continuous Quinidine Gluconate Infusion in the Treatment of Severe Chloroquine-Resistant Plasmodium Falciparum Malaria

The drug of choice in the treatment of chloroquine-resistant Plasmodium falciparum malaria is parenteral quinine dihydrochloride. Due to limited use, the drug is not commercially available in the U.S. and must be obtained through the Centers for Disease Control (CDC) in Atlanta, Georgia. As an alternative, the CDC has developed a protocol to treat P. falciparum malaria with parenteral quinidine gluconate. Following this protocol, a 10 mg/kg loading dose of quinidine gluconate followed by a 0.02 mg/kg/min continuous infusion was administered to a 53-year-old man with severe life-threatening chloroquine-resistant P. falciparum malaria. Although the patient described did not survive, the use of parenteral quinidine gluconate still appears to be a viable alternative to parenteral quinine dihydrochloride in the treatment of severe chloroquine-resistant P. falciparum malaria.