High risk of QT interval prolongation and torsades de pointes associated with intravenous quinidine used for treatment of resistant malaria or babesiosis

Antimicrob Agents Chemother. 2012 Aug;56(8):4495-9. doi: 10.1128/AAC.06396-11. Epub 2012 May 21.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antimalarials / adverse effects*
  • Antimalarials / therapeutic use
  • Arrhythmias, Cardiac / chemically induced*
  • Babesiosis / drug therapy*
  • Babesiosis / physiopathology
  • Female
  • Heart / drug effects
  • Heart Rate / drug effects
  • Humans
  • Long QT Syndrome / chemically induced*
  • Malaria / drug therapy*
  • Malaria / physiopathology
  • Male
  • Middle Aged
  • Quinidine / adverse effects*
  • Quinidine / therapeutic use
  • Risk Factors
  • Torsades de Pointes / chemically induced*

Substances

  • Antimalarials
  • Quinidine