Antimalarial drug resistance
Nicholas J. White
Nicholas J. White
Published April 15, 2004
Citation Information: J Clin Invest. 2004;113(8):1084-1092. https://doi.org/10.1172/JCI21682.
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Antimalarial drug resistance

Abstract

Malaria, the most prevalent and most pernicious parasitic disease of humans, is estimated to kill between one and two million people, mainly children, each year. Resistance has emerged to all classes of antimalarial drugs except the artemisinins and is responsible for a recent increase in malaria-related mortality, particularly in Africa. The de novo emergence of resistance can be prevented by the use of antimalarial drug combinations. Artemisinin-derivative combinations are particularly effective, since they act rapidly and are well tolerated and highly effective. Widespread use of these drugs could roll back malaria.

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Nicholas J. White

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Pharmacodynamics: the parasite reductions produced by the different anti...
Pharmacodynamics: the parasite reductions produced by the different antimalarial drugs in vivo (in an adult patient with 2% parasitemia). Parasite reduction ratios (PRR; fractional reduction per asexual cycle) vary from less than 10 (antibiotics with antimalarial activity, antimalarials for which resistance is high grade) to 10,000 (artemisinin derivatives). Antimalarial drugs must be present at levels greater than the minimum inhibitory concentration (MIC) until eradication of the infection in nonimmune patients to ensure cure of the infection. Adapted with permission from from Trends in Parasitology (60).