Quinine – a time for re-evaluation?

Abstract

Quinine was the drug of choice for severe malaria until 2005 and was used extensively in South Africa for this purpose. As discussed in this issue of the SAJCC by Mathiba et al. from Chris Hani Baragwanath Hospital (CHBH), two large randomised controlled trials (SEAQUAMAT (South East Asian Quinine Artesunate Malaria Trial) and AQUAMAT (African Quinine v. Artesunate Malaria Trial)) conducted in adults and children, respectively found that mortality was significantly lower with intravenous artesunate and as such it became the recommended agent for severe malaria.