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Am. J. Trop. Med. Hyg., 52(2), 1995, pp. 159-161
Copyright © 1995 by The American Society of Tropical Medicine and Hygiene

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Activity of Azithromycin as a Blood Schizonticide against Rodent and Human Plasmodia In Vivo

S. L. Andersen, A. Ager, P. McGreevy, B. G. Schuster, D. Wesche, R. Kuschner, C. Ohrt, W. Ellis, R. Rossan AND J. Berman
Division of Experimental Therapeutics and Division of Communicable Diseases and Immunology, Walter Reed Army Institute of Research, Washington, District of Columbia; Center for Tropical Parasitic Diseases, Department of Microbiology and Immunology, Miami, Florida; Gorgas Memorial Laboratory, Panama, Panama

We compared the efficacy of azithromycin to the clinical antimalarial doxycycline in Plasmodium berghei-infected mice and in P. falciparum-infected Aotus monkeys. When mice were administered drug orally twice a day for three days, the minimum total dose of azithromycin that cured all mice was 768 mg/kg. Doxycycline at a dose of 1,536 mg/kg cured no mice. The efficacy of fast-acting blood schizonticides (quinine, halofantrine, artemisinin) against P. berghei was augmented by azithromycin. In monkey experiments in which there were two animals per experimental group, azithromycin (100 mg/kg/day for seven days) eliminated parasitemia; azithromycin (30 mg/kg/day) initially cleared 99.8–100% of the parasites with recrudescence in the one completely cleared case. Doxycycline (30 mg/kg/day) cleared 100% of the parasites with recrudescence in both cleared cases. Since azithromycin can be clinically administered at a somewhat higher daily dosage than doxycycline, the data suggest that it may be possible to replace drugs of the tetracycline class with azithromycin in combination with fast-acting blood schizonticides for the treatment of P. falciparum infection.




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Copyright © 1995 by the American Society of Tropical Medicine and Hygiene.