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Leptospirosis has recently been described to cause concomitant infection with malaria. Only doxycycline has proven to have chemoprophylactic and therapeutic efficacy for both malaria and leptospirosis. To assess whether other traditional antimalarial agents have antileptospiral activity, we performed broth microdilution susceptibility testing of 16 Leptospira serovars (6 species/14 serogroups) to various agents. Artemisinin, atovaquone, chloroquine, mefloquine, primaquine, proguanil, pyrimethamine, sulfadoxine, quinine, quinidine, and combinations of atovaquone/proguanil and pyrimethamine/sulfadoxine all had a 90% minimum inhibitory concentration (MIC90) > 25 µg/mL (the upper limit of testing). The only agents identified with the potential to treat both infections other than doxycycline (MIC90 = 1.56 µg/mL) were azithromycin (MIC90 = 0.002 µg/mL) and clindamycin (MIC90 = 0.2 µg/mL).
Received April 10, 2004. Accepted for publication May 5, 2004.
Acknowledgment: This work was presented in part at the 52nd Annual Meeting of the American Society of Tropical Medicine and Hygiene, Philadelphia, PA, December 2003.
Disclaimer: The views expressed herein are those of the authors and do not reflect the official policy or position of the Department of the Army, the Department of Defense, or the U.S. Government.
Authors address: Clinton K. Murray, Michael W. Ellis, and Duane R. Hospenthal, Infectious Disease (MCHE-MDI), Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, Telephone: 210-916-4355, Fax: 210-916-0388, E-mails: Clinton. Murray{at}amedd.army.mil, Michael.Ellis2{at}amedd.army.mil, and Duane.Hospenthal{at}amedd.army.mil.
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