Dr. Murai Éva szerk.: Parasitologia Hungarica 26. (Budapest, 1993)

included in group 2a and treated with the quinine + quinidine combination. This combination eliminated parasitaemia from all patients. No recrudescence was seen in this group. Fifteen patients of group 2b were treated with quinine + quinidine once. The clearance time of parasites and fever was much shorter in this group than in the quinine group. No recrudescence was seen. The data indicate that between quinine and quinidine a synergism exists, rather than merely a simple addition of their effects. Moreover, quinine is not what it used to be...(Smit 1987). Commercial quinine sulphate contains - besides quinine sulphate - dihydroquinine sulphate 6%. The situation is the same with quinidine sulphate. This means that the combination of 300 mg of quinine and 200 mg of quinidine contains, besides the two drugs, 18 mg dihydroquinine and 12 mg of dihydroquinidine. The future of this combination may be very promising: it will make it possible to reduce the period of antimalarial treatment and improve its efficacy*. No significant difference in parasite clearance time was seen between groups 2a and 2b. Compared with the combination of quinine and quinidine, a poor effect of chloroquine was seen in the group from the highly chloroquine-resistant area of South Vietnam (Table 1). The in vitro data of Axmann et al. (1988) correlate well with the in vivo data of the present study. The comparison of the therapeutic effects of quinine, chloroquine and the quinine + quinidine combination suggests that the last one has a good perspective in the treatment of chloroquine-resistant Plasmodium falciparum malaria. The advantages of the quinine + quinidine combination can be summarized as follows: (1) It reduces the dose and/or shortens the duration of antimalarial treatment. (2) The use of a combination of drugs rather than a single agent could limit the development of resistant strains in the future. (3) The reduced dose of each component helps to avoid side effects like that of quinidine on the heart. Axmann A. és Anh T. K.: Chloroquine-rezisztens maláriában (Plasmodium falciparum) szenvedő betegek eredményes kezelése quinine és quinidine kombinációjával A trópusi malária kórokozójának, a Plasmodium falciparum-nak a gyógyszerrezisztenciája egyre fokozódó problémát jelent mind a betegség megelőzésében, mind pedig gyógyításában. A kutatók igyekezete új, hatásos gyógyszerek vagy gyógyszerkombinációk kimunkálására irányul. Ez utóbbit célozta meg jelen tanulmány szerzőinek munkája is. Ennek kapcsán egy régi, a szívgyógyászatban használatos szerről, a quinidine-ről bizonyították be in vivo jó terápiás hatékonyságát. Sztereoizomerjével, a quinine-nel kombinálva lehetővé vált a hatásos dózis csökkentése, ezáltal elkerülhetők voltak a szívhatások, az antimaláriás hatás megőrzése mellett. Since this study was carried out, the combination of these compounds has already been commercialized under the name Quinimax (I.a Baz Laboratoire, Paris), which is the drug of first choice in the treatment of chloroquine-resistant P. f malaria in East Africa.