Malaria in humait a county, state of Amazonas, Brazil. XIX - evaluation of clindamycin for the treatment of patients with Plasmodium falciparum infection

Revista da Sociedade Brasileira de Medicina Tropical

Domingos Alves Meira²  Paulo Camara Marques Pereira²  Jussara Marcondes-machado²  Rinaido Poncio Mendes²  Benedito Barraviera²  José Antonio G. Pirola²  Maria Regina Cotrim Guimarães²  Paulo Roberto Curi¹  Renato Pedro Rodrigues² 

[1] ,Faculdade de Medicina Departamento de Moléstias Infecciosas e Parasitárias, Dermatologia e Radiologia

关键词: treatment;    Plasmodium falciparum;    Clindamycin;    Tratamento da malária;    Plasmodium falciparum;    Clindamicina;   

DOI  :  10.1590/S0037-86821988000300005

来源: SciELO

【 摘 要 】

A total of 207 patients with malaria caused by Plasmodium falciparum were submitted to 5 different treatment schedules with clindamycin from 1981 to 1984: A - 89 patients were treated intravenously and orally, or intramuscularly and orally with 20 mg/kg/day divided into two daily applications for 5 to 7 days; B-40 patients were treated orally with 20 mg/kg/day divided into two daily doses for 5 to 7 days; C-27 patients were treated with 20 mg/kg/day intravenously or orally divided into two daily applications for 3 days; D-16 patients were treated orally and/or intravenously with a single daily dose of 20 to 40 mg/kg/day for 5 to 7 days; E-35 patients were treated orally with 5 mg/kg/day divided into two doses for 5 days. Patients were examined daily during treatment and reexamined on the 7th, 24th, 21st, 28th and 35th day both clinically and parasitologically (blood test). Eighty three (40.1%) had moderate or severe malaria, and 97 (46.8%) had shown resistance to chloroquine or to the combination ofsulfadoxin and pyrimethamine. The proportion of cured patients was higher than 95% among patients submitted to schedules A and B. Side effects were only occasional and of low intensity. Three deaths occurred (1.4%), two of them involving patients whose signs and symptoms were already very severe when treatment was started. Thus, clindamycin proved to be very useful in the treatment of patients with malaria caused by Plasmodium falciparum and we recommend schedule A for moderate and severe cases and Bfor initial cases.

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