We previously showed that quaternary ammonium salts have potent antimalarial activities against the blood stage of drug-resistant Plasmodium falciparum. In the present study, 13 compounds of this series were comparatively assessed in murine in vivo malarial models. Mice infected with Plasmodium berghei were successfully treated with 11 quaternary ammonium salts in a 4-day suppressive test with a once-daily intraperitoneal administration. The dose required to decrease parasitemia by 50% (ED 50 ) ranged from 0.04 to 4.5 mg/kg of body weight. For six mono-and three bis-quaternary ammonium salts, the therapeutic indices (i.e., 50% lethal dose and ED 50 ) were higher than 5, and at best, around 20 to 30 for five of them (E6, E8, F4, G5, and G25), which is comparable to that of chloroquine under the same conditions. Plasmodium chabaudi was significantly more susceptible to G5, G15, and G25 compounds than P. berghei. Similar therapeutic indices were obtained, regardless of the administration mode or initial parasitemia (up to 11.2%). Parasitemia clearance was complete without recrudescence. Subcutaneously administered radioactive compounds had a short elimination half-life in mice (3.5 h) with low bioavailability (17.3%), which was likely due to the permanent cationic charge of the molecule. The high in vivo therapeutic index in the P. chabaudi-infected mouse model and the absence of recrudescence highlight the enormous potential of these quaternary ammonium salts for clinical malarial treatment.In the absence of vaccines, and due to the widespread resistance to antimalarials in current use, new chemotherapies are urgently needed to help in the prevention and control of malaria. The most promising strategy is to strive to discover new chemically diverse entities directed towards novel biological targets. Potential chemotherapeutic targets in the malaria parasite can be broadly classified into three categories: those involved in processes occurring in the digestive vacuole, enzymes involved in macromolecular and metabolite synthesis, and those responsible for membrane processes and signaling. The potential of putative targets to be validated will be tapped to develop effective and safe drugs (14,17,29).We previously characterized phospholipid (PL) metabolism as an attractive target for new malaria chemotherapy due to its vital importance to the parasite. PL metabolism is absent from normal mature human erythrocytes (19), but the erythrocyte PL content increases by as much as 500% after infection, specifically due to the metabolic machinery of the parasite (10, 18). Phosphatidylcholine is the major PL of infected erythrocytes, representing about 45% of the total PL. In this pathway, choline transport which regulates the supply of polar head precursors to the parasite is a regulatory rate-limiting step (3,22,23). PL polar head analogs are able to interfere with PL biosynthesis and exhibit antimalarial activity against the intraerythrocytic stage of Plasmodium falciparum in vitro (24). More particularly, 36 compounds which...