Simplified antimalarial therapeutic monitoring: using the day-7 drug level?

Trends Parasitol. 2008 Apr;24(4):159-63. doi: 10.1016/j.pt.2008.01.006. Epub 2008 Mar 19.

Abstract

The blood concentration profiles of most antimalarial drugs vary considerably between patients. The interpretation of antimalarial drug trials evaluating efficacy and effectiveness would be improved considerably if the exposure of the infecting parasite population to the antimalarial drug treatment could be measured. Artemisinin combination treatments are now recommended as first-line drugs for the treatment of falciparum malaria. Measurement of the blood, serum or plasma concentration of the slowly eliminated partner antimalarial drug on day 7 of follow-up is simpler and might be a better determinant of therapeutic response than the area under the concentration-time curve. Measurement of the day-7 drug level should be considered as a routine part of antimalarial drug trials.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antimalarials / blood*
  • Antimalarials / pharmacokinetics*
  • Antimalarials / therapeutic use
  • Area Under Curve
  • Artemisinins / blood
  • Artemisinins / pharmacokinetics
  • Artemisinins / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Humans
  • Malaria / blood*
  • Malaria / drug therapy*
  • Microbial Sensitivity Tests
  • Treatment Outcome

Substances

  • Antimalarials
  • Artemisinins