We agree fully that the lack of a ready supply of IV quinidine at American hospitals is troubling. Indeed, we initially expressed this concern 4 years ago after an experience similar to that of Albrecht et al, but it seems that the problem persists.1 Our retrospective study of 121 malaria cases in San Francisco, Calif, included only 1 case of severe malaria.2 However, potentially lethal Plasmodium falciparum malaria occurs regularly throughout the United States, and urgent treatment of this condition is mandatory. Quinidine remains the only parenteral medication that is available in the United States to treat severe malaria; therefore, it would be prudent for all hospitals to have rapid access to this drug.
Dorsey G, Rosenthal PJ. Quinidine and Malaria—Reply. Arch Intern Med. 2001;161(8):1118–1119. doi: