Early treatment failure in severe malaria resulting from abnormally low plasma quinine concentrations.
Newton PN., Ward S., Angus BJ., Chierakul W., Dondorp A., Ruangveerayuth R., Silamut K., Teerapong P., Suputtamongkol Y., Looareesuwan S., White NJ.
A patient admitted with severe Plasmodium falciparum malaria in western Thailand had an early treatment failure with quinine, despite full dosing. Plasma quinine concentrations were subtherapeutic. Abnormal quinine pharmacokinetics may explain sporadic reports of quinine treatment failures in severe malaria.