Antimalarial dosing regimens and drug resistance

被引:111
作者
Barnes, Karen I. [1 ]
Watkins, William M. [2 ]
White, Nicholas J. [2 ,3 ]
机构
[1] Univ Cape Town, Dept Med, Div Clin Pharmacol, ZA-7925 Cape Town, South Africa
[2] Univ Oxford, Ctr Clin Vaccinol & Trop Med, Nuffield Dept Med, Oxford, England
[3] Mahidol Univ, Fac Trop Med, Bangkok, Thailand
关键词
D O I
10.1016/j.pt.2007.11.008
中图分类号
R38 [医学寄生虫学]; Q [生物科学];
学科分类号
07 ; 0710 ; 09 ; 100103 ;
摘要
The contribution of underdosing to antimalarial treatment failure has been underappreciated. Most recommended dosage regimens are based on studies in non-pregnant adult patients. Young children and pregnant women, who bear the heaviest malaria burden, have the highest treatment failure rates. This has been attributed previously to lower immunity, although blood concentrations of many antimalarial drugs are significantly lower in pregnant women and young children than in non-pregnant adults. Nevertheless, there have been no studies of higher dosages. Sub-therapeutic concentrations will certainly contribute to poorer responses to treatment and will fuel the emergence and spread of antimalarial drug resistance. There is an urgent need for studies to optimise antimalarial dosage regimens in infants, young children and pregnant women, both to improve cure rates and to prolong the useful therapeutic lives of antimalarial drugs.
引用
收藏
页码:127 / 134
页数:8
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