How antimalarial drug resistance affects post-treatment prophylaxis.
Slowly eliminated antimalarial drugs suppress malaria reinfections for a period of time determined by the dose, the pharmacokinetic properties of the drug, and the susceptibility of the infecting parasites. This effect is called post-treatment prophylaxis (PTP). The clinical benefits of preventing recrudescence (reflecting treatment efficacy) compared with preventing reinfection (reflecting PTP) need further assessment. Antimalarial drug resistance shortens PTP. While blood concentrations are in the terminal elimination phase, the degree of shortening may be estimated from measurements of in-vitro susceptibility and the terminal elimination half-life. More information is needed on PTP following intermittent preventive treatments, and on the relationship between the duration of PTP and immunity, so that policy recommendations can have a firmer evidence base.
White
Nicholas J
NJ
Mahidol-Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd,, Bangkok 10400, Thailand. nickw@tropmedres.ac
D019072:Antibiotic Prophylaxis; D000962:Antimalarials / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004351:Drug Resistance / Q000187:drug effects*; D006801:Humans; D007109:Immunity / Q000187:drug effects; D008288:Malaria / Q000188:drug therapy* / Q000517:prevention & control*; D010599:Pharmacokinetics; D012008:Recurrence
D000962:Antimalarials