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Treatment of Plasmodium falciparum malaria with pyrimethamine-sulfadoxine: selective pressure for resistance is a function of long elimination half-life
Abstract
In an area of continuing transmission of Plasmodium falciparum on the Kenya coast, children treated with pyrimethamine-sulfadoxine experienced rapid parasite clearance, although a high proportion became reinfected within a short time. The frequency of pyrimethamine resistance in vitro in new infections was higher during the elimination phase of drug from a previous treatment. In infections which occurred at times when predicted residual drug concentrations were no longer inhibitory, incidence of pyrimethamine resistance was no different from the natural or background frequency. These results are discussed in terms of the selective pressure for resistance which is exerted by drugs with long elimination half-lives and a consideration of possible ways by which the problem might be addressed.
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Citations
Cited by
White, N. J. (2004) · Journal of Clinical Investigation · doi:10.1172/jci200421682 · Cited by 1,248
White, N., Nosten, F., Looareesuwan, S., Watkins, W., Marsh, K., Snow, R., Kokwaro, G., Ouma, J., Hien, T., Molyneux, M., et al. (1999) · The Lancet · doi:10.1016/s0140-6736(98)07367-x · Cited by 543
Self-citationMechanisms of Resistance of Malaria Parasites to Antifolates
Gregson, A., & Plowe, C. V. (2005) · Pharmacological Reviews · doi:10.1124/pr.57.1.4 · Cited by 499
Current status of malaria and potential for control
Phillips, R. S. (2001) · Clinical Microbiology Reviews · doi:10.1128/cmr.14.1.208-226.2001 · Cited by 266
Preventing antimalarial drug resistance through combinations
White, N. J. (1998) · Drug Resistance Updates · doi:10.1016/s1368-7646(98)80208-2 · Cited by 259
Metadata
- Authors
- Watkins, W. M., & Mosobo, M.
- Venue
- Transactions of the Royal Society of Tropical Medicine and Hygiene
- Publisher
- Oxford University Press (OUP)
- Published
- 1993-01
- Volume
- 87
- Issue
- 1
- Pages
- 75-78
- ISSN
- 0035-9203 (ISSN-L)
- OpenAlex
- W2059838568
- Cited by
- 209
- References
- 0
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Treatment of Plasmodium falciparum malaria with pyrimethamine-sulfadoxine: selective pressure for resistance is a function of long elimination half-life. https://app.cochat.ai/papers/10.1016/0035-9203(93)90431-o
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- Watkins, W. M., & Mosobo, M. (1993). Treatment of Plasmodium falciparum malaria with pyrimethamine-sulfadoxine: selective pressure for resistance is a function of long elimination half-life. Transactions of the Royal Society of Tropical Medicine and Hygiene. https://doi.org/10.1016/0035-9203(93)90431-o
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
