The efficacy of antifolate antimalarial combinations in Africa: A predictive model based on pharmacodynamic and pharmacokinetic analyses


Journal Article (Review)

At present, effective treatment for non-severe malaria is the most important malaria control strategy in Africa. Pyrimethamine-sulfadoxine (PSD) is rapidly becoming the first-line treatment in areas of chloroquine resistance, although the parasite chemoresistance factors that dispose towards clinical failure with PSD are still unclear. Here, Bill Watkins and colleagues analyse the relationship between the pharmacokinetic properties of two treatment combinations (PSD and chlorproguanil-dapsone) in vivo and the respective in vitro isobolograms for parasites with specific drug-resistance patterns. From this relationship, they develop a hypothesis that may explain clinical drug failure and differential efficacy between treatments. The deductions can be tested in field studies to validate or refute the model.

Duke Authors

Cited Authors

  • Watkins, WM; Mberu, EK; Winstanley, PA; Plowe, CV

Published Date

  • January 1, 1997

Published In

Volume / Issue

  • 13 / 12

Start / End Page

  • 459 - 464

International Standard Serial Number (ISSN)

  • 0169-4758

Citation Source

  • Scopus