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The susceptibility of Plasmodium falciparum to sulfadoxine and pyrimethamine: correlation of in vivo and in vitro results.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 1986 Mar; Vol. 35 (2), pp. 239-45. - Publication Year :
- 1986
-
Abstract
- In 1982, 2 of 14 Plasmodium falciparum infections acquired in East Africa and diagnosed in Copenhagen were resistant to treatment with sulfadoxine plus pyrimethamine (Fansidar), while in 1983, 6 of 18 were so. The in vivo tests were supplemented by determinations of drug concentrations in serum, and 4 isolates from in vivo-sensitive cases and 6 from in vivo-resistant cases were selected for in vivo tests. These were performed in ordinary RPMI 1640 medium and in a medium with physiological p-aminobenzoic acid and folic acid concentrations. Pharmacokinetic aberrations were found to be of possible importance in only 2 of the in vivo-resistant cases. In vitro susceptibility to sulfadoxine was found to be uniformly low in all isolates. Testing with a combination of sulfadoxine and pyrimethamine in the medium with physiological concentrations of cofactors probably reflects the in vivo situation most accurately, but in all but 1 of the isolates studied in vitro the in vivo susceptibility to Fansidar would be predicted by in vitro susceptibility to pyrimethamine in either medium. The concentration of p-aminobenzoic acid in serum, quantitated by high performance liquid chromatography, was found to be subject to wide variation, and this may have implications for in vitro testing.
- Subjects :
- Adult
Antimalarials metabolism
Antimalarials pharmacology
Antimalarials therapeutic use
Drug Combinations metabolism
Drug Combinations pharmacology
Drug Combinations therapeutic use
Drug Resistance, Microbial
Humans
In Vitro Techniques
Malaria parasitology
Microbial Sensitivity Tests
Plasmodium falciparum drug effects
Pyrimethamine metabolism
Pyrimethamine pharmacology
Sulfadoxine metabolism
Sulfadoxine pharmacology
Malaria drug therapy
Pyrimethamine therapeutic use
Sulfadoxine therapeutic use
Sulfanilamides therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9637
- Volume :
- 35
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 3513641
- Full Text :
- https://doi.org/10.4269/ajtmh.1986.35.239