Ciprofloxacin does not achieve radical cure of Plasmodium falciparum infection in Sierra Leone.
Recently, activity in vivo of norfloxacin has been reported against Plasmodium falciparum and, in vitro, ciprofloxacin has been found to be even more potent than norfloxacin. We therefore treated one patient infected with chloroquine-resistant P. falciparum at relatively low parasite density with ciprofloxacin, 200 mg intravenously twice daily for 3 d. This treatment failed to produce radical cure, although some suppressive effect was probably obtained. The growth of the P. falciparum isolate in vitro was inhibited at 12.5 micrograms/ml, whereas the plasma concentration recorded 1 h after infusion was only 1.2 microgram/ml. It is concluded that, if ciprofloxacin is to be used for treatment of malaria, a higher dose than that normally used for bacterial infections is necessary.
Strömberg
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Danderyd Hospital, Sweden.
Björkman
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D000818:Animals; D002738:Chloroquine / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004351:Drug Resistance; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D010963:Plasmodium falciparum / Q000187:drug effects; D011739:Pyrimethamine / Q000627:therapeutic use; D012807:Sierra Leone; D013413:Sulfadoxine / Q000627:therapeutic use; D016896:Treatment Outcome
D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D002939:Ciprofloxacin; D013413:Sulfadoxine; D002738:Chloroquine; D011739:Pyrimethamine