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Antimicrobial Agents and Chemotherapy, September 2002, p. 2889-2894, Vol. 46, No. 9
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.9.2889-2894.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

In Vitro and In Vivo Synergy of Fosmidomycin, a Novel Antimalarial Drug, with Clindamycin

Jochen Wiesner,^1,2* Dajana Henschker,² David B. Hutchinson,^2, Ewald Beck,¹ and Hassan Jomaa²

Institute of Biochemistry, Academic Hospital Centre, Justus-Liebig-University,¹ Jomaa Pharmaka GmbH, D-35392 Giessen, Germany²

Received 7 January 2002/ Returned for modification 3 May 2002/ Accepted 11 June 2002

Fosmidomycin acts through inhibition of 1-deoxy-D-xylulose 5-phosphate (DOXP) reductoisomerase, a key enzyme of the nonmevalonate pathway of isoprenoid biosynthesis. It possesses potent antimalarial activity in vitro and in murine malaria. In a recent clinical study, fosmidomycin was effective and well tolerated in the treatment of patients with acute uncomplicated Plasmodium falciparum malaria but resulted in an unacceptably high rate of recrudescence. In order to identify a potential combination partner, the interaction of fosmidomycin with a number of antimalarial drugs in current use was investigated in a series of in vitro experiments. Synergy was observed between fosmidomycin and the lincosamides, lincomycin and clindamycin. The efficacy of a combination of fosmidomycin and clindamycin was subsequently demonstrated in the Plasmodium vinckei mouse model.

Present address: Betsoms Farmhouse, Westerham, Kent, TN16 2DR, United Kingdom.

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