Quinine given through the rectum may be as effective as intravenous and intramuscular quinine for treating uncomplicated Plasmodium falciparum malaria. The data reviewed also lead to the conclusion that a diluted proprietary quinine solution (made less acidic by adjustment to a pH of 4.5) given intrarectally using a syringe for two to three days has less harmful effects compared with intramuscular quinine given for the same time period. Administration of intrarectal quinine (made less acidic by adjustment to a pH of 4.5) is significantly less painful than intramuscular injection of quinine. More trials are needed for patients with severe malaria and in adults.
This review is an updated version of Intrarectal quinine for treating Plasmodium falciparum malaria.
Eisenhut, M.; Omari, A.A.A. Intrarectal quinine versus intravenous or intramuscular quinine for treatingPlasmodium falciparummalaria. Cochrane Database of Systematic Reviews (2009) (Issue 1) Art. No.: CD004009. [DOI: 10.1002/14651858.CD004009.pub3]