Key result
Intravenous quinidine for severe parasitic infection is linked to high rates of QT prolongation and TdP.
Why the study?
Cardiac toxicity including torsades de pointes is a known risk of quinidine, but the risk at higher intravenous doses used for resistant malaria or babesiosis is not well characterized.
Does intravenous quinidine cause QT interval prolongation and Torsades de pointes in patients treated for resistant malaria or babesiosis?
Case Report (n=6)
Does intravenous quinidine cause QT interval prolongation and Torsades de pointes in patients treated for resistant malaria or babesiosis?
Intravenous quinidine used for resistant malaria or babesiosis carries a high risk of QT interval prolongation and Torsades de pointes due to the high doses required.
Warrants close QT monitoring with IV quinidine; hypothesis-generating given small case series.
Cardiac toxicity may be associated with drugs used for malaria. Torsades de pointes (TdP) is a well-known adverse effect of quinidine when used for atrial fibrillation. Intravenous quinidine doses for resistant malaria are 2 to 3 times higher than those used for arrhythmias. Among 6 patients receiving quinidine for malaria or babesiosis, 4 developed QT interval prolongation and 2 experienced TdP. Clinicians should be aware that recommended doses of quinidine for malaria carry a high TdP risk.
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Wroblewski et al. (2012) conducted a case report in Resistant malaria or babesiosis (n=6). Intravenous quinidine was evaluated on QT interval prolongation. Intravenous quinidine for malaria or babesiosis was associated with QT interval prolongation in 4 of 6 patients (66.7%) and Torsades de pointes in 2 of 6 patients (33.3%).
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