Primaquine, an anti-malarial drug is given to prevent malaria relapses and data on its pharmacokinetics is lacking in children.
We studied the pharmacokinetics and safety of a single oral dose of Primaquine (0.3mg/kg) in normally nourished and
malnourished children with P.vivax malaria. After IRB approval and consent or assent, children were classified as normally
nourished (Group I) and those with Protein Energy Malnutrition (PEM, Group II) according to Indian Academy of Pediatrics
classification. Five ml blood samples were collected predose and at 1, 2, 3, 4, 6, 8 and 24 hrs post dose. Plasma Primaquine
concentration was analyzed by High Performance Liquid Chromatography (HPLC) and PKSolutions 2.0
Pharmacokinetic Data analysis software was used for analysis.
The single dose was safe. Overall, no significant difference in pharmacokinetics between normally nourished and under
nourished children was found between Groups I and II (9.65 � 4.74, 13.02 � 12.8) and AUC (0-α)(ng.hr/ml) (78.71 � 35.53,
180.73 � 256.47) respectively. However, when this data was compared to results from another study in adults, we found that the
dose adjusted Cmax [Adults 2.90 � 1.8 ng/ml] and AUC (0-α) [adults 24.1 � 12.88 ng.hr/ml] was significantly higher in children
irrespective of nutritional status suggesting the need to reduce the pediatric dose.
Sarfaraz R. Momin is currently pursuing his MD in the field of pediatrics at Seth G.S. Medical college and KEM Hospital, Mumbai, India. He has completed his MBBS from Karnataka Institute of Medical Sciences (KIMS), Hubli, India. He stood first and second in his institution in first and final year of MBBS respectively. He was also the topper in Physiology, Pediatrics and Obstetrics and Gynecology subjects in his institution. He has secured Distinctions and was topper throughout his schooling. He has presented two cases in the metabolic liver conference held in Mumbai in 2012.
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