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Antimicrobial Agents and Chemotherapy, September 2005, p. 3749-3754, Vol. 49, No. 9
0066-4804/05/$08.00+0     doi:10.1128/AAC.49.9.3749-3754.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Short-Course Regimens of Artesunate-Fosmidomycin in Treatment of Uncomplicated Plasmodium falciparum Malaria

Steffen Borrmann,1,2,{dagger} Ayola A. Adegnika,1,2 Félicien Moussavou,1,3 Sunny Oyakhirome,1 Gilbert Esser,1,2 Pierre-Blaise Matsiegui,1,2 Michael Ramharter,4 Ingrid Lundgren,1,5 Maryvonne Kombila,3 Saadou Issifou,1,2 David Hutchinson,6 Jochen Wiesner,7 Hassan Jomaa,7 and Peter G. Kremsner1,2*

Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon,1 Department of Parasitology, Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany,2 Département de Parasitologie-Mycologie, Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon,3 Division of Infectious Diseases, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria,4 Mayo Medical School, Mayo Clinic, Rochester, Minnesota,5 Jomaa Pharma GmbH, Hamburg, Germany,6 Institute of Biochemistry, University of Giessen, Giessen, Germany7

Received 24 December 2004/ Returned for modification 8 February 2005/ Accepted 30 June 2005

Fosmidomycin is effective against malaria, but it needs to be given for ≥4 days when used alone. We conducted a study of 50 children with Plasmodium falciparum malaria to evaluate the safety and efficacy of consecutively shortened regimens of artesunate-fosmidomycin (1 to 2 mg/kg of body weight and 30 mg/kg of body weight, respectively; doses given every 12 hours). All dosing regimens were well tolerated. Artesunate-fosmidomycin acted rapidly, resulting in consolidated geometric mean parasite and fever clearance times of 24 h and 15 h, respectively. Treatment regimens of ≥2 days led to cure ratios of 100% by day 14 (39/39; 95% confidence interval [95% CI], 91% to 100%). Most importantly, the 3-day regimen achieved 100% cure on day 28 (10/10; 95% CI, 69% to 100%). Treatment with artesunate-fosmidomycin was associated with transient grade I or II neutropenia (absolute neutrophil counts of 750 to 1,200/µl and 400 to 749/µl, respectively) in six or two patients, respectively. Artesunate-fosmidomycin demonstrates the feasibility and potential value of short-course artemisinin-based combination chemotherapy with rapidly eliminated combination partners.

* Corresponding author. Mailing address: Institute of Tropical Medicine, Wilhelmstrasse 27, 72074 Tübingen, Germany. Phone: 49-7071-29-87179. Fax: 49-7071-29-5189. E-mail: peter.kremsner{at}uni-tuebingen.de.

{dagger} Present address: Kenya Medical Research Institute-Wellcome Trust Collaborative Research Programme, Kilifi, Kenya.

Antimicrobial Agents and Chemotherapy, September 2005, p. 3749-3754, Vol. 49, No. 9
0066-4804/05/$08.00+0     doi:10.1128/AAC.49.9.3749-3754.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Tahar, R., Basco, L. K. (2007). Molecular Epidemiology of Malaria in Cameroon. XXV. In Vitro Activity of Fosmidomycin and its Derivatives against Fresh Clinical Isolates of Plasmodium falciparum and Sequence Analysis of 1-Deoxy-D-Xylulose 5-Phosphate Reductoisomerase. Am J Trop Med Hyg 77: 214-220 [Abstract] [Full Text]  
  • Borrmann, S., Lundgren, I., Oyakhirome, S., Impouma, B., Matsiegui, P.-B., Adegnika, A. A., Issifou, S., Kun, J. F. J., Hutchinson, D., Wiesner, J., Jomaa, H., Kremsner, P. G. (2006). Fosmidomycin plus Clindamycin for Treatment of Pediatric Patients Aged 1 to 14 Years with Plasmodium falciparum Malaria.. Antimicrob. Agents Chemother. 50: 2713-2718 [Abstract] [Full Text]  


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