tetracycline and Malaria

Topics: Animals; Antimalarials; Humans; Life Cycle Stages; Liver; Malaria; Plasmodium; Structure-Activity Relationship

The records of 20 children with imported malaria admitted to Kings County Hospital between October 1987 and May 1995 were reviewed. All had a history of recent travel or immigration from a malaria endemic area (West-Africa [16], Central-America [three], and the Caribbean [one]). None of the 10 children with a travel history received appropriate malaria chemoprophylaxis. The most common symptoms and signs were daily fever, chills, and hepatomegaly. Diagnosis was delayed in seven children who were initially felt to have pharyngitis or viral syndrome. Common laboratory findings were anemia and thrombocytopenia. P. falciparum was identified in 70% of the patients. Other species were P. malariae and P. vivax. Complications occurred in six children, hyponatremia in five, seizures in three, and cerebral malaria in one patient. The high incidence of chloroquine-resistant malaria makes chemoprophylaxis difficult in children. The clinical presentation of malaria is nonspecific, and diagnostic delays occur, so a high index of suspicion is needed in children with a travel history.

Topics: Animals; Antimalarials; Child; Child, Preschool; Drug Therapy, Combination; Female; Fever; Hepatomegaly; Humans; Malaria; Male; Plasmodium falciparum; Quinine; Splenomegaly; Tetracycline; Travel; Treatment Outcome; Tropical Climate

Topics: Antimalarials; Dapsone; Drug Interactions; Humans; Malaria; Proguanil; Pyrimethamine; Quinolines; Sulfadoxine; Tetracycline

Topics: Amebiasis; Animals; Antibodies; Babesiosis; Chloroquine; Drug Resistance, Microbial; Giardiasis; Humans; Leishmaniasis; Malaria; Mefloquine; Pneumocystis; Pneumonia, Pneumocystis; Primaquine; Protozoan Infections; Pyrimethamine; Quinine; Quinolines; Serologic Tests; Sulfadoxine; Tetracycline; Toxoplasmosis; Trypanosomiasis

Malaria is not a disease of the past. As long as worldwide eradication has not been achieved there is a close connection between countries which export it and those which import it. If the European doctor is presently confronted with a feverish disease which may have been brought in from a tropical area, he should immediately think of malaria and take the necessary measures for treatment. If patients or travelers come into the office and enquire about drugs and preventive measures against malaria, the doctor must choose the correct methods. This is best done by two questions: Where have you come from? and Where are you going? In this way the doctor can obtain ideas on the possibility of resistant strains of parasite in the region in question. Tourists should not forget that a rational and regular chemoprophylaxis is the best protection against serious attacks of malaria.

Topics: Adolescent; Adult; Amodiaquine; Child; Child, Preschool; Chloroquine; Dose-Response Relationship, Drug; Female; Humans; Infant; Insect Repellents; Malaria; Male; Plasmodium falciparum; Plasmodium malariae; Plasmodium vivax; Pregnancy; Pyrimethamine; Quinine; Sulfadiazine; Sulfadoxine; Tetracycline

Topics: Amphotericin B; Anthelmintics; Bithionol; Cestode Infections; Chloroquine; Humans; Intestinal Diseases, Parasitic; Leishmaniasis; Malaria; Metronidazole; Nematode Infections; Quinacrine; Tetracycline; Thiabendazole

Topics: Animals; Antimalarials; Drug Resistance, Microbial; Folic Acid Antagonists; Humans; Malaria; Phenanthrenes; Plasmodium; Plasmodium falciparum; Plasmodium malariae; Plasmodium vivax; Pyrimethamine; Quinine; Quinolines; Sulfadiazine; Sulfisoxazole; Sulfonamides; Sulfones; Tetracycline

Topics: Amodiaquine; Anopheles; Antimalarials; Asia; Chloroquine; Drug Resistance, Microbial; Humans; Insect Vectors; Malaria; Mutation; Plasmodium falciparum; Primaquine; Proguanil; Quinine; South America; Sulfonamides; Sulfones; Tetracycline; Virulence

Topics: Chloroquine; Drug Resistance; Geography; Humans; Malaria; Methylamines; Naphthacenes; Plasmodium falciparum; Pyrazines; Pyrimethamine; Pyrimidines; Quinine; Sulfamethoxazole; Sulfonamides; Tetracycline; Thailand; Trimethoprim

Topics: Anti-Bacterial Agents; Humans; Malaria; Protein Synthesis Inhibitors; Tetracycline

The purpose of this study was to compare an experimental regimen of atovaquone plus proguanil with the standard regimen of quinine plus tetracycline for the treatment of uncomplicated falciparum malaria. The study was designed as an open, randomized study of men presenting with symptoms of uncomplicated malaria and thick-smear slide confirmation of parasitemia (1000-100,000 ring forms/microL). Subjects were hospitalized for 28 days to insure medication compliance and to rule out the possibility of reinfections. With 77 patients in each group, the cure rates were 98.7% and 100% for atovaquone plus proguanil and quinine plus tetracycline, respectively. The parasite clearance times (mean, 56 h) and fever clearance times (mean, 19 h) were significantly shorter in the atovaquone plus proguanil group, and there were significantly fewer side effects in the atovaquone plus proguanil group. Atovaquone plus proguanil is an efficacious, easily administered, safe regimen for the treatment of uncomplicated, multidrug-resistant falciparum malaria in Brazil.

Topics: Adolescent; Adult; Aged; Antimalarials; Atovaquone; Brazil; Drug Therapy, Combination; Humans; Malaria; Male; Middle Aged; Naphthoquinones; Proguanil; Quinine; Tetracycline

A double blind study of daily doxycycline (100 mg) vs. weekly mefloquine (250 mg) was performed on United States soldiers training in Thailand to assess the effect of doxycycline malaria prophylaxis on the incidence of gastrointestinal infections. During a 5 week period, 49% (58/119) of soldiers receiving doxycycline and 48% (64/134) of soldiers receiving mefloquine reported an episode of diarrhea. Infection with bacterial enteric pathogens was identified in 39% (47/119) of soldiers taking doxycycline and 46% (62/134) of soldiers taking mefloquine. Forty-four percent (59/134) of soldiers receiving mefloquine and 36% (43/119) of soldiers receiving doxycycline were infected with enterotoxigenic Escherichia coli (ETEC), while 9% (12/134) of soldiers receiving mefloquine and 4% of soldiers receiving doxycycline were infected with Campylobacter. Side effects from either medication were minimal. After 5 weeks in Thailand, the percent of non-ETEC strains resistant to greater than or equal to 2 antibiotics increased from 65% (77/119) to 86% (95/111) in soldiers on mefloquine and from 79% (84/106) to 93% (88/95) in soldiers on doxycycline. Doxycycline prophylaxis did not prevent or increase diarrheal disease in soldiers deployed to Thailand where ETEC and other bacterial pathogens are often resistant to tetracyclines.

Topics: Adolescent; Adult; Animals; Bacterial Infections; Campylobacter; Cryptosporidium; Diarrhea; Double-Blind Method; Doxycycline; Drug Resistance, Microbial; Escherichia coli; Gastrointestinal Diseases; Humans; Malaria; Male; Mefloquine; Military Personnel; Random Allocation; Tetracycline; Thailand

Three different regimens were compared for treatment of falciparum malaria in displaced Kampucheans living in encampments on the Thai-Kampuchean border in 1983: single dose 750 mg mefloquine, 1.5 g sulfadoxine, 75 mg pyrimethamine (MSP); 600 mg quinine 8-hourly for 3 days and 500 mg tetracycline 8-hourly for 7 days (Q3T7); or 600 mg quinine 8-hourly for 7 days and 500 mg tetracycline 8-hourly for 7 days (Q7T7). Radical cure rates were 98% (40/41) for MSP, 76% (32/42) for Q3T7 and 92% (33/36) for Q7T7. The criterion for treatment failure was reappearance of parasites by 35 days after commencement of treatment or no parasite clearance. Treatment failures comprised one case of reduction but no clearance of parasites (RII resistance) for MSP, 10 recrudescences (RI) for Q3T7 and 3 recrudescences (RI) for Q7T7. The radical cure rate for Q3T7 was significantly lower than that for MSP (P less than 0.01), whilst Q7T7 significantly from the other groups. Parasite clearance time was shorter (2.4 days) with MSP than with Q3T7 (3.5 days) and Q7T7 (3.3 days). There was little difference in side effects between the regimens, and tolerance was good. The MSP and Q7T7 regimens are both effective for treatment, but the single dose of MSP is much easier to manage than 7 days of quinine and tetracycline.

Topics: Cambodia; Drug Therapy, Combination; Humans; Malaria; Mefloquine; Plasmodium falciparum; Plasmodium vivax; Pyrimethamine; Quinine; Quinolines; Sulfadoxine; Sulfanilamides; Tetracycline; Thailand

A trial of drug regimens for treating Plasmodium falciparum malaria was conducted in a refugee camp in eastern Thailand where extensive 'Fansidar' (pyrimethamine-sulfadoxine) resistance had been demonstrated. The efficacy of quinine alone was compared to that of quinine combined with either fansidar or tetracycline. Quinine alone cleared the parasitaemia in 57 of 59 patients but failed to cure approximately one-third of these patients after 7 or 10 days of therapy. The addition of fansidar to quinine therapy did not significantly improve the overall cure rate. Tetracycline given for 10 days in combination with quinine cured all patients, suggesting that tetracycline should be considered in treating patients with falciparum malaria contracted in the area of the Thai-Kampuchean border.

Topics: Child; Drug Combinations; Drug Therapy, Combination; Humans; Malaria; Plasmodium falciparum; Pyrimethamine; Quinine; Sulfadoxine; Sulfanilamides; Tetracycline; Thailand

Topics: Administration, Oral; Chloroquine; Drug Resistance, Microbial; Drug Synergism; Humans; Malaria; Plasmodium falciparum; Quinine; Tetracycline; Thailand; Time Factors

In this study, it was aimed to investigate the antimalarial activity of cinnamaldehyde (CIN) and cannabidiol (CBD) which have shown various biological activities such as potent antimicrobial activity and eravacycline (ERA), a new generation tetracycline derivative, in an in vivo malaria model. The cytotoxic activities of the active substances were determined by the MTT method against L929 mouse fibroblasts and their antimalarial activity were determined by the four-day test in an in vivo mouse model. In this study, five groups were formed: the CIN group, the CBD group, the ERA group, the chloroquine group (CQ) and the untreated group (TAG). 2.5 x 107 parasites/mL of P.berghei-infected erythrocyte suspension was administered IP to all mice. The determined doses of active substances were given to the mice by oral gavage in accordance with the four-day test and the parasitemia status in the mice was controlled for 21 days with smear preparations made from the blood taken from the tail end of the mice. The IC50 values, which express the cytotoxic activity values of the active substances were determined as 27.55 μg/mL, 16.40 μM and 48.82 μg/mL for CIN, CBD and ERA, respectively. The mean parasitemia rate in untreated mice was 33% on day nine and all mice died on day 11. On the ninth day, when compared with the TAG group, no parasites were observed in the CIN group, while the average parasitemia was 0.08% in the CBD group and 17.8% in the ERA group. Compared to the mice in the TAG group, the life expectancy of the other groups was prolonged by eight days in the CIN group, 12 days in the CBD group and eight days in the ERA group. It has been determined that all three active subtances tested in this study suppressed the development of Plasmodium parasites in an in vivo mouse model and prolonged the life span of the mice. It is thought that the strong antimalarial activity of CIN and CBD shown in the study and the possible positive effect of ERA on the clinical course can be improved by combining them with the existing and potential antimalarial molecules.

Topics: Animals; Antimalarials; Cannabidiol; Malaria; Mice; Parasitemia; Plant Extracts; Plasmodium berghei; Tetracycline

Eravacycline is a novel synthetic halogenated tetracycline derivative with a broad antibacterial spectrum. Antibiotics, including tetracyclines, have been used for prophylaxis and, more rarely, for the treatment of malaria for several decades. The rise in drug-resistant malaria parasites renders the search for new treatment candidates urgent. We determined the in vitro potency of eravacycline against Plasmodium falciparum and investigated the apicoplast as a potential drug target.. Four tetracyclines, including eravacycline, tetracycline, tigecycline, and doxycycline, and the lincosamide clindamycin, were tested in 3-day and 6-day in vitro susceptibility assays of P. falciparum laboratory strain 3D7 and/or of clinical isolates obtained from 33 P. falciparum infected individuals from Gabon in 2018. Assays with isopentenyl pyrophosphate substitution were performed to investigate whether apicoplast-encoded isoprenoid biosynthesis is inhibited by these antibiotics.. Eravacycline showed the highest activity of all tetracyclines tested in clinical isolates in the 3-day and 6-day assays. Substitution of isopentenyl pyrophosphate in vitro using the laboratory strain 3D7 reversed the activity of eravacycline and comparator antibiotics, indicating the apicoplast to be the main target organelle.. These results demonstrate the potential of novel antibiotics, and eravacycline, as candidate antimalarial therapies.

Topics: Animals; Anti-Bacterial Agents; Humans; Malaria; Parasites; Plasmodium falciparum; Tetracycline; Tetracyclines

The Wolrd Health Organization (WHO) encourages all countries to investigate antimalarial drug substances derived from herbal sources with the slogan "Hunt of the Next Artemisinin" due to the emergence of resistant strains of Plasmodium species to artemisinin. In the broad and simple sense, it was planned to help guide the young researchers set in-vitro and in-vivo models of malaria in order to be used in drug research and active ingredient studies.. In-vitro study, young Plasmodium berghei trophozoites were removed from the liquid nitrogen tank and resuspended in appropriate conditions, followed by incubation with chloroquine and tetracycline at concentrations of 0.1, 0.4, 0.8, 1.6, 6.4, 12.8 μg/mL for 24 hours at +37°C in a shaking incubator. In-vivo studies, Tetracycline group (TG) and Chloroquine group (KG) were administered 50 mg/kg of tetracycline and chloroquine by intragastric lavage and untreated control group (TACG) were administered the same amount of saline via the same route. The suppression of parasitemia in mice was followed for 24 days.. In our in-vitro study it was observed that 0.8 μg/mL of chloroquine and 1.6 μg/mL of tetracycline was enough to suppress parasitemia. In our in-vivo drug study, all of the mice in the TG group died at day 24, and all of the mice in the TAKG group died at day 12, with no parasitemia observed in the mice in the KG group.. Our study suggests that if tetracycline therapy is administered when the induction of chloroquine therapy is delayed, the exacerbation of the parasitemia may be prevented and when chloroquine is obtained chloroquine therapy can be commenced thus preventing the loss of the patient.

Topics: Animals; Antimalarials; Artemisinins; Chloroquine; Disease Models, Animal; Drug Evaluation, Preclinical; In Vitro Techniques; Malaria; Male; Mice; Mice, Inbred BALB C; Plant Extracts; Plasmodium berghei; Tetracycline

We report a case of borreliosis mimicking uncomplicated malaria in a patient returning from Mali. Identification of spirochetes through examination of a thick blood smear completed by an acridine-orange quantitative buffy coat allowed the diagnosis of borreliosis. All symptoms rapidly resolved following tetracycline therapy. Epidemiological and clinical features of borreliosis, diagnostic tools and management are discussed.

Topics: Anti-Bacterial Agents; Borrelia Infections; Diagnosis, Differential; Fever; France; Humans; Malaria; Male; Mali; Middle Aged; Tetracycline; Travel

Isolated cases of malaria are increasing in frequency in nonendemic countries. Blood film examination remains a mainstay of diagnosis of these sporadic cases because immunologic and molecular methods are unavailable, expensive, and problematic. Two tertian malarial species, Plasmodium vivax and Plasmodium ovale, may appear to be similar morphologically. Plasmodium ovale infection is infrequent, and misdiagnosis of this species is common. Plasmodium vivax infection can be ruled out, however, if a patient's erythrocytes phenotype as Fy(a-b-), because these cells completely resist entry by the latter species.

Topics: Animals; Child, Preschool; Diagnosis, Differential; Drug Therapy, Combination; Duffy Blood-Group System; Erythrocytes; Humans; Immunophenotyping; Malaria; Male; Plasmodium; Primaquine; Quinine; Tetracycline

Anopheles darlingi fed on eight falciparum malaria patients with gametocytes before and after treatment with quinine sulfate or quinine sulfate plus tetracycline became infected. Quinine and quinine plus tetracycline had no apparent sporontocidal or gametocytocidal effect on late stage immature and mature gametocytes. Plasmodium falciparum gametocytes are persistent and infected mosquitoes for up to 21 days after patients were treated with quinine plus tetracycline. Sporogonic development was similar for groups of mosquitoes fed before and after patients were treated with these schizontocides. The percentages of infected mosquitoes that developed salivary gland infections were also similar for groups of mosquitoes fed before and after treatment. Twenty-four hours after treatment with 45 mg of primaquine phosphate, falciparum malaria patients were not infective to An. darlingi.

Topics: Animals; Anopheles; Drug Therapy, Combination; Female; Humans; Malaria; Male; Plasmodium falciparum; Quinine; Salivary Glands; Tetracycline

Rhodamine 123 (Rh 123) was used as a fluorescent probe for the mitochondria of the malarial parasite Plasmodium falciparum. On treatment with tetracycline in vitro, a marked decrease in the percentage of parasites with Rh123 fluorescence in the mitochondria was observed in parallel with an increase in the percentage of parasites with abnormal morphology during onset of decrease in parasitemia. Similar results were obtained, over a shorter time period, with 2,4-dinitrophenol. However, the percentage of parasites with fluorescence did not decrease with increase in parasite abnormal morphology or decrease in parasitemia on treatment with pyrimethamine or cycloheximide. Isoelectric focusing-SDS gel electrophoresis of radiolabelled parasite proteins showed two components of 95 and 85 kDa, the synthesis of which was sensitive to tetracycline, but not cycloheximide. It is concluded that tetracycline exerts its action through the effect on parasite mitochondria and mitochondrial protein synthesis.

Topics: 2,4-Dinitrophenol; Animals; Cycloheximide; Dinitrophenols; Electrophoresis, Polyacrylamide Gel; Humans; In Vitro Techniques; Malaria; Mitochondria; Plasmodium falciparum; Protein Synthesis Inhibitors; Pyrimethamine; Rhodamine 123; Rhodamines; Tetracycline; Uncoupling Agents

Forty-three patients were enlisted in the in-vivo test for sensitivity of Kampuchean strains of Plasmodium falciparum to quinine. The mean parasite density count on day 0 was 32,398 asexual parasites per microliter of blood. With a dosage of 1.5 g quinine base daily for 10 days the average parasite clearance time was 5.6 days, and the average duration of fever 3.4 days. The in-vivo test was evaluated at 7 and 10 days after the start of therapy. After 7 days only 16 patients were parasite negative by microscopic examination (S); 20 patients had an RI recrudescence, four patients responded at the RII level and three at the RIII level. Evaluating the in-vivo test at 10 days, the number of patients parasite negative increased to 18, the number of those with an RI level of resistance increased to 21, two patients gave an RII response and two had an RIII level of resistance. Twenty-two adult males were included in an in-vivo test of the sensitivity of P. falciparum to quinine plus tetracycline. The course of treatment was: quinine 3 x 500 mg daily for 10 days, tetracycline 3 x 500 mg for 7 days. Parasite density counts on day 0 averaged 11,393 asexual parasites per microliter of blood. The average parasite clearance time was 5.9 days, and the average duration of fever was 3.8 days. After 7 days of treatment, 81.8% of patients were parasite negative, while one patient had a recrudescence after 17 days (RI). Three infections were resistant at the RII level. By prolongation of the observations to day 10, the parasitaemia was cleared in all patients, i.e. all infections were sensitive to quinine plus tetracycline. Thirty-four patients with falciparum malaria were screened for in-vitro resistance to chloroquine, mefloquine and quinine using the WHO standard micro-test.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Animals; Cambodia; Chloroquine; Drug Administration Schedule; Drug Resistance; Drug Therapy, Combination; Humans; In Vitro Techniques; Malaria; Male; Mefloquine; Middle Aged; Plasmodium falciparum; Quinine; Quinolines; Tetracycline

Chloroquine-resistant plasmodium falciparum malaria has been described in many parts of the world, including Africa as far south as south-western Africa. We report a case of chloroquine-resistant P. falciparum cerebral malaria in the RSA. It seems likely that the infection was acquired in the Louis Trichardt district of the northern Transvaal. Despite the administration of an adequate course of chloroquine, the parasitaemia failed to clear and even increased (type III resistance). Eventually clinical and laboratory-proven cure was obtained only after combined quinine and tetracycline therapy. To our knowledge this is the first case of chloroquine-resistant P. falciparum malaria acquired in the RSA.

Topics: Adolescent; Chloroquine; Drug Resistance, Microbial; Drug Therapy, Combination; Female; Humans; Malaria; Plasmodium falciparum; Quinine; Tetracycline

In Eastern Thailand the increasing resistance of Plasmodium falciparum to all available antimalarial drugs prompted a reassessment of chloroquine in combination with either erythromycin or tetracycline. Both combinations had produced encouraging results in vitro, in experimental animal models, or in preliminary clinical trials. In patients with uncomplicated falciparum malaria presenting with moderate parasitaemia the trial of chloroquine and tetracycline was abandoned after RIII resistance with clinical deterioration was encountered in 2 out of the first 5 patients studied. Of 16 patients treated with chloroquine+erythromycin, 11 showed resistance (RI-RIII). These regimens appear ineffective and potentially dangerous in Eastern Thailand.

Topics: Adolescent; Adult; Child; Chloroquine; Drug Resistance; Drug Therapy, Combination; Erythromycin; Female; Humans; Malaria; Male; Middle Aged; Plasmodium falciparum; Tetracycline; Thailand

Topics: Amodiaquine; Chloroquine; Drug Resistance; Drug Therapy, Combination; Humans; Malaria; Plasmodium falciparum; Tetracycline

Chloroquine-resistant Plasmodium falciparum malaria has been described in East, Central and West Africa. We report on 2 patients with probable chloroquine-resistant P. falciparum malaria in south-western Africa. Both patients had been in northern SWA/Namibia and southern Angola, but had taken prophylactic chloroquine. Despite the subsequent administration of adequate courses of chloroquine therapy, the parasitaemias failed to clear completely. Eventual clinical and laboratory-proven cure was only obtained in 1 case after combined quinine and tetracycline therapy. To our knowledge, these represent the first cases of probable chloroquine-resistant P. falciparum malaria acquired in this area.

Topics: Adult; Africa, Southern; Africa, Western; Animals; Chloroquine; Drug Resistance, Microbial; Humans; Malaria; Male; Plasmodium falciparum; Pyrimethamine; Quinine; Tetracycline

Topics: Chloroquine; Drug Therapy, Combination; Humans; Malaria; Tetracycline; Travel

Topics: Adolescent; Age Factors; Child; Child, Preschool; Dental Enamel; Humans; Malaria; Tetracycline

A combination of the drugs amodiaquine and tetracycline was used in a clinical trial at Phrabuddhabat Hospital in Central Thailand for treating Plasmodium falciparum malaria. Of the 51 patients who completed the 28-day follow-up, 49 (96%) were cured; in two cases the parasitaemia was cleared within seven days of initial therapy but returned within 28 days (RI response). Only one patient experienced a mild and transient side effect of nausea. The treatment regimen was cheap and the drugs are readily available commercially. Results of this study suggest that amodiaquine-tetracycline combination offers a practical, safe and highly effective method for treating uncomplicated falciparum malaria.

Topics: Adolescent; Adult; Aged; Amodiaquine; Drug Therapy, Combination; Female; Humans; Malaria; Male; Middle Aged; Plasmodium falciparum; Tetracycline; Thailand

Topics: Adolescent; Adult; Drug Resistance, Microbial; Drug Therapy, Combination; Female; Humans; Malaria; Male; Plasmodium falciparum; Quinine; Tetracycline

Topics: Adolescent; Chloroquine; Drug Administration Schedule; Drug Combinations; Drug Resistance, Microbial; Female; Humans; Malaria; Plasmodium falciparum; Pyrimethamine; Quinine; Sulfadoxine; Sulfanilamides; Tetracycline

A case of Plasmodium falciparum malaria resistant to chloroquine occurring in a patient taking Fansidar (a combination of pyrimethamine and sulphadoxine) regularly as prophylaxis is reported. It seems likely that the malaria infection was acquired in Tanzania. It is probable that more such cases will be seen, and complacency regarding the emergence of drug-resistant P. falciparum malaria should be guarded against. It is predicted that chloroquine and Fansidar resistance will be increasingly found in a wider area of Africa, including South Africa. A brief review of drug-resistant P. falciparum malaria is presented and alternative therapy discussed.

Topics: Adult; Chloroquine; Drug Resistance; Drug Therapy, Combination; Humans; Malaria; Male; Plasmodium falciparum; Pyrimethamine; Quinine; Tetracycline

Topics: Animals; Erythromycin; Haplorhini; Malaria; Minocycline; Plasmodium; Tetracycline; Tetracyclines

Imported malaria has been increasing in the United States. Locally acquired cases are reported in drug addicts. Extended incubation periods can be misleading. Pyrexia is the most common manifestation, but it may not follow a regular pattern. A high index of suspicion and examination of peripheral blood smears establish the diagnosis. Chloroquine and primaquine are the drugs of choice for uncomplicated malaria; quinine sulfate is preferred in the treatment of chloroquine-resistant malaria. Malarial prophylaxis should include travelers' education and chemoprophylactic agents such as chloroquine, chloroguanide, pyrimethamine and amodiaquine.

Topics: Aged; Child; Chloroquine; Drug Resistance; Drug Therapy, Combination; Health Education; Humans; Malaria; Pyrimethamine; Quinine; Sulfadiazine; Tetracycline; Travel

Topics: Acetamides; Amebiasis; Chloroquine; Drug Combinations; Drug Resistance, Microbial; Emetine; Humans; Malaria; Nitroimidazoles; Protective Devices; Pyrimethamine; Sulfadoxine; Tetracycline

Topics: Amebicides; Anti-Inflammatory Agents; Antimalarials; Ascariasis; Benzenesulfonates; Cestode Infections; Echinococcosis; Entamoebiasis; Hookworm Infections; Humans; Malaria; Niclosamide; Niridazole; Oxyuriasis; Parasitic Diseases; Paromomycin; Pyrantel Pamoate; Schistosomiasis; Strongyloidiasis; Tartrates; Tetrachloroethylene; Tetracycline; Thiabendazole; Toxocariasis; Trichinellosis

An individual infected with a multidrug-resistant strain of Plasmodium falciparum failed to respond to treatment with sulfalene and pyrimethamine. Subinoculation studies showed that parasite resistance to the drug combination was not present. Plasma levels of sulfalene and pyrimethamine in this individual were similar to those of three individuals, subinoculated from him, who were cured by the drug combination. Erythrocyte levels of sulfalene in this individual were similar to those in an individual, subinoculated from him, who was cured by the drug combination. After treatment with the drug combination, in vitro tests showed similar antimalarial activity in the serum of this individual in comparison with the serum of this individual in comparison with the serum of an individual subinoculated from him. The failure of this individual to respond to treatment with sulfalene and pyrimethamine is attributed to an undefined host factor (or factors) that appear(s) to be present in his erythrocytes.

Topics: Adult; Amodiaquine; Drug Resistance; Drug Therapy, Combination; Erythrocytes; Humans; Malaria; Male; Phenotype; Plasmodium falciparum; Pyrazines; Pyrimethamine; Sulfanilamides; Sulfonamides; Tetracycline

Clindamycin, a semi-synthetic antibiotic of the lincomycin family, at a dose of 450 mg eight-hourly for three days in adults cured five out of 10 patients moderately ill with chloroquine-resistant falciparum malaria. Combination therapy with full-dose quinine and clindamycin for three days cured all four patients so treated who were followed up, and with half dosage three out of five patients were cured. Both combinations, however, caused upper gastrointestinal toxicity and appeared to potentiate both toxicity and possibly antimalarial efficacy. Colitis due to clindamycin was not observed. Sequential therapy was not toxic and could be useful in patients who have relapsed after more conventional treatment.

Topics: Blood; Child; Chloroquine; Clindamycin; Colitis; Digestive System; Drug Resistance; Drug Therapy, Combination; Humans; Malaria; Male; Plasmodium falciparum; Quinine; Tetracycline

Topics: Animals; Chloroquine; Drug Combinations; Drug Resistance, Microbial; Malaria; Mice; Minocycline; Plasmodium berghei; Rodent Diseases; Spectrum Analysis; Tetracycline

Topics: Africa; Antimalarials; Asia; Central America; Chloroquine; Dapsone; Drug Resistance, Microbial; Drug Therapy, Combination; Greece; Humans; Malaria; Pacific Islands; Plasmodium falciparum; Primaquine; Recurrence; South America; Sulfonamides; Sulfones; Tetracycline; Travel; USSR

Topics: Africa; Asia; Brucellosis; Chloramphenicol; Chloroquine; Fever; Humans; Leishmaniasis, Visceral; Liver Abscess, Amebic; Malaria; Metronidazole; Plasmodium falciparum; Tetracycline; Travel; Trypanosomiasis, African; Tuberculosis; Typhoid Fever; United Kingdom

The progressive spread in Asia and South America of falciparum malaria resistant to 4-aminoquinolines, and the focal occurrence in all malarious regions of infections resistant to dihydrofolate dehydrogenase inhibitors such as pyrimethamine and proguanil, make it everywhere necessary to be alert to the failure of accepted curative, prophylactic, or sporontocidal chemotherapeutic agents. Resistance to 4-aminoquinolines may be met curatively with courses of treatment lasting 1-14 days, or more, the longer courses relying on quinine, often with a sulfonamide, or on tetracyclines, and the shorter courses on associations of sulfonamides or sulfones with pyrimethamine or trimethoprim. Suppressive prophylaxis of these infections is obtained by the injection at 3-month intervals of a repository mixture of acedapsone and cycloguanil, or by the weekly ingestion of sulfadoxine, sulfalene, or diformyl-dapsone associated with pyrimethamine, or the daily ingestion of dapsone with proguanil. Primaquine, although continuing to be an efficient sporontocide of P. falciparum when pyrimethamine and proguanil no longer suffice, is becoming less effective in preventing relapses of P. vivax in countries around New Guinea.

Topics: Africa; Antimalarials; Asia; Central America; Dapsone; Drug Resistance; Drug Therapy, Combination; Humans; Malaria; Male; Plasmodium falciparum; South America; Sulfonamides; Tetracycline; Time Factors

Topics: Adolescent; Adult; Anti-Infective Agents; Blood; Child; Drug Combinations; Folic Acid Antagonists; Humans; Malaria; Middle Aged; Plasmodium falciparum; Pyrimidines; Quinine; Sulfamethoxazole; Tetracycline; Thailand; Trimethoprim

Topics: Adolescent; Adult; Drug Synergism; Drug Therapy, Combination; Evaluation Studies as Topic; Female; Humans; Malaria; Male; Middle Aged; Plasmodium falciparum; Pyrimethamine; Quinine; Tetracycline; Thailand

Topics: Animals; Drug Resistance, Microbial; Malaria; Mice; Minocycline; Plasmodium berghei; Tetracycline

Topics: Humans; Malaria; Tetracycline

Topics: Fever; Humans; Malaria; Tetracycline; Time Factors

Topics: Asia, Southeastern; Drug Resistance, Microbial; Drug Synergism; Humans; Malaria; Male; Military Medicine; Plasmodium falciparum; Quinine; Tetracycline

Topics: Acute Disease; Adolescent; Adult; Antimalarials; Humans; Malaria; Male; Methylamines; Middle Aged; Plasmodium falciparum; Quinine; Tetracycline; Thailand

Topics: Anopheles; Chloroquine; Drug Resistance; Erythrocytes; Humans; Malaria; Male; Minocycline; Plasmodium falciparum; Tetracycline; Vietnam

Topics: Child, Preschool; Humans; Infant; Malaria; Plasmodium falciparum; Tetracycline

Topics: Animals; Humans; Malaria; Quinine; Tetracycline

Topics: Chloroquine; Drug Combinations; Humans; Malaria; Quinine; Tetracycline

Topics: Adult; Body Temperature; Chloroquine; Doxycycline; Humans; Malaria; Male; Middle Aged; Oxytetracycline; Plasmodium falciparum; Plasmodium vivax; Tetracycline; Time Factors

Topics: Administration, Oral; Body Temperature; Chloroquine; Drug Resistance, Microbial; Humans; Malaria; Male; Plasmodium falciparum; Quinine; Recurrence; Tetracycline; Time Factors

Topics: Animals; Antineoplastic Agents; Azaserine; Chloramphenicol; Chloroquine; Cycloheximide; Cytoplasm; Dactinomycin; Injections, Intraperitoneal; Malaria; Male; Mercaptopurine; Mice; Mitomycins; Nucleic Acids; Pigments, Biological; Plasmodium; Protein Biosynthesis; Puromycin; Streptomycin; Tetracycline; Uracil

Topics: Abscess; Blood Chemical Analysis; Humans; Inhalation; Malaria; Male; Middle Aged; Splenic Diseases; Tetracycline; Urine

Topics: Chemoprevention; Child; Communicable Disease Control; Humans; Malaria; Penicillins; Preventive Medicine; Rheumatic Fever; Sexually Transmitted Diseases; Streptococcal Infections; Tetracycline; Tuberculosis; Whooping Cough

Topics: Animals; Antimalarials; Characidae; Disulfiram; Malaria; Mice; Plasmodium berghei; Quinine; Tetracycline

Topics: Animals; Antimalarials; Characidae; Chickens; Disulfiram; Malaria; Meat; Plasmodium gallinaceum; Quinine; Tetracycline