title: Tetracyclines in malaria.
abstract: Malaria, a parasite vector-borne disease, is one of the greatest health threats in tropical regions, despite the availability of malaria chemoprophylaxis. The emergence and rapid extension of Plasmodium falciparum resistance to various anti-malarial drugs has gradually limited the number of potential malaria therapeutics available to clinicians. In this context, doxycycline, a synthetically derived tetracycline, constitutes an interesting alternative for malaria treatment and prophylaxis. Doxycycline is a slow-acting blood schizontocidal agent that is highly effective at preventing malaria. In areas with chloroquine and multidrug-resistant P. falciparum parasites, doxycycline has already been successfully used in combination with quinine to treat malaria, and it has been proven to be effective and well-tolerated. Although not recommended for pregnant women and children younger than 8 years of age, severe adverse effects are rarely reported. In addition, resistance to doxycycline is rarely described. Prophylactic and clinical failures of doxycycline have been associated with both inadequate doses and poor patient compliance. The effects of tetracyclines on parasites are not completely understood. A better comprehension of the mechanisms underlying drug resistance would facilitate the identification of molecular markers of resistance to predict and survey the emergence of resistance.
authors.affiliation: Unité de Parasitologie, Département d'Infectiologie de Terrain, Institut de Recherche Biomédicale des Armées, Marseille, France. tiphaine.rousselgaillard@gmail.com.|Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix Marseille Université, Marseille, France. tiphaine.rousselgaillard@gmail.com.|Fédération des Laboratoires, Hôpital d'Instruction des Armées Saint Anne, Toulon, France. tiphaine.rousselgaillard@gmail.com.
authors.forename: Tiphaine
authors.initials: T
authors.lastname: Gaillard
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix Marseille Université, Marseille, France. mmadamet@gmail.com.|Equipe Résidente de Recherche en Infectiologie Tropicale, Institut de Recherche Biomédicale des Armées, Hôpital d'Instruction des Armées, Marseille, France. mmadamet@gmail.com.|Centre National de Référence du Paludisme, Marseille, France. mmadamet@gmail.com.
authors.forename: Marylin
authors.initials: M
authors.lastname: Madamet
authors.affiliation: Unité de Parasitologie, Département d'Infectiologie de Terrain, Institut de Recherche Biomédicale des Armées, Marseille, France. bruno.pradines@free.fr.|Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix Marseille Université, Marseille, France. bruno.pradines@free.fr.|Centre National de Référence du Paludisme, Marseille, France. bruno.pradines@free.fr.|Unité de Parasitologie et d'Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France. bruno.pradines@free.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pradines
mesh_terms: D000962:Antimalarials / Q000494:pharmacology* / Q000627:therapeutic use*; D004318:Doxycycline / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D008288:Malaria / Q000188:drug therapy* / Q000517:prevention & control*; D010961:Plasmodium / Q000187:drug effects*
chemical_list: D000962:Antimalarials; D004318:Doxycycline