Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clindamycin 450 mg every 8 hours for 3 days cured three non-immune patients of falciparum malaria, although the response was slow. The addition of quinine to this regimen provided an accelerated response and cured 3 of 5 other patients. Single doses of clindamycin given daily for 3 days, with or without quinine, cured 1 of 3 patients. Gastric intolerance to the drugs, probably accentuated by the clinical condition, was pronounced in some cases, the course of treatment being interrupted in three patients for this reason. Chesson strain Plasmodium vivax relapses in man were not inhibited by ingestion of 450 mg of clindamycin every 6 hours for 14 days.
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PMID:Antimalarial effects of clindamycin in man. 109 Nov 72

Clindamycin, a semi-synthetic antibiotic of the lincomycin family, at a dose of 450 mg eight-hourly for three days in adults cured five out of 10 patients moderately ill with chloroquine-resistant falciparum malaria. Combination therapy with full-dose quinine and clindamycin for three days cured all four patients so treated who were followed up, and with half dosage three out of five patients were cured. Both combinations, however, caused upper gastrointestinal toxicity and appeared to potentiate both toxicity and possibly antimalarial efficacy. Colitis due to clindamycin was not observed. Sequential therapy was not toxic and could be useful in patients who have relapsed after more conventional treatment.
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PMID:Falciparum malaria semi-resistant to clindamycin. 109 9

Clinical trials on oral clindamycin as an antimalarial in hospitalized patients and residents of endemic communities were conducted in the Philippines between May 1984 and December 1985. Seven and 9 qualified subjects in hospital were treated with 300 mg (regimen A) and 600 mg (regimen B) respectively, twice daily for 5 days. Eighteen patients seen at a rural health unit were given the lower dosage. On the basis of the 28-day extended in vivo test of WHO, P. falciparum in all but one patient showed susceptibility to the drug as a blood schizontocide hence, the clinical cure of malaria. Side effects were few and self-limiting. Ten other patients on regimen A were cured within the 7- and/or 28-day extended test period. Clindamycin per se is currently one of the few alternatives in the treatment of clinically moderate drug-resistant malaria.
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PMID:Oral clindamycin in the treatment of acute uncomplicated falciparum malaria. 207 81

Forty cases of imported malaria (1978 to 1988) are reviewed and management principles are discussed. All 15 cases of Plasmodium falciparum malaria were acquired in Africa, 5 of which were probably chloroquine-resistant. Most cases of Plasmodium vivax (80%) were acquired on the Indian subcontinent, including 2 cases of congenital malaria. Six children developed P. falciparum malaria despite chemoprophylaxis. All children had a history of fever, usually with other influenza-like symptoms. Two-thirds had splenomegaly, and one-third were afebrile on admission. Thrombocytopenia (70%) and anemia (70%) were often present. Forty-five percent received previous wrong diagnoses and treatments. Quinine or quinidine with either Fansidar or clindamycin were used to treat P. falciparum malaria. Clindamycin may be more effective if given for 7 instead of 3 days. There were no deaths or residual complications. As the prevalence and severity of drug-resistant P. falciparum spreads, prophylaxis and treatment choices become more difficult. Diagnosis requires a travel history and a high index of suspicion.
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PMID:Review of 40 children with imported malaria. 259 48

Clindamycin, 5 mg/kg twice a day for 5 days, was used to treat falciparum malaria after clinical and parasitological diagnosis at a health station in Faki Hashim, a suburb of Khartoum, Sudan. Twenty out of twenty-six patients enrolled completed the study. Giemsa-stained thick blood films were negative for asexual parasites by day 7 in 17 patients and by day 8 in the remaining 3. All were examined on days 14 or 28; 2 who had initially been cleared by day 6 had asymptomatic low density asexual parasitemia on day 14, which disappeared without treatment by day 28, and 2 others initially cleared by day 5 were similarly positive at day 28. Reinfection in these patients cannot be ruled out. Of the 6 patients withdrawn from the study, 2 took chloroquine independently, 1 developed vomiting, 1 developed diarrhea, 1 acquired a circumoral maculopapular rash, and 1 had an increasing parasitemia on day 3 and was switched to chloroquine. Generally, the treatment was without toxicity and was well received. Clindamycin proved satisfactory for the treatment of simple cases of falciparum malaria in the field in Africa.
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PMID:Clindamycin for the treatment of falciparum malaria in Sudan. 391 44

A randomized comparative trial for treating adult patients with Plasmodium falciparum malaria was performed in Lambarene, Gabon. Forty-two patients received chloroquine (25 mg/kg for 48 hr) and 38 patients received clindamycin (5 mg/kg twice a day, for five days). Chloroquine treatment cured 15 patients (36%). Twenty patients (48%) showed recrudescent malaria by day 28 of follow-up (RI resistance) and seven patients (17%) showed persistent parasitemia after chloroquine treatment (RII/III resistance). In contrast, clindamycin treatment cured 37 of 38 patients (97%) and only one (3%) showed a recrudescence by day 28 (P < 0.001). Although the parasite clearance time was significantly longer after clindamycin treatment (median five days, range 3-6) than after chloroquine treatment (median four days, range 2-8) (P < 0.01), no differences were seen in the duration of symptoms after chemotherapy. In both treatment groups, no severe side effects occurred. Clindamycin can be used as a safe alternative to achieve radical cure in semi-immune adult patients with chloroquine-resistant P. falciparum malaria in Central Africa.
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PMID:Curing of chloroquine-resistant malaria with clindamycin. 825 Jan 7

Therapeutic responses to clindamycin in combination with quinine were assessed in adult Thai patients with uncomplicated multidrug-resistant Plasmodium falciparum malaria. In total 204 patients were randomized to receive a 7-day oral treatment regimen of quinine (Q(7)) either alone (n = 68), in combination with clindamycin (Q(7)C(7); n = 68), or in combination with tetracycline (Q(7)T(7); n = 68). All patients had uncomplicated recoveries with no serious adverse effects. Fever clearance times for both of the two combination regimens (median of 47 h and range of 8 to 120 h for Q(7)C(7) and median of 36 h and range of 8 to 117 h for Q(7)T(7)) were significantly shorter than that for the Q(7)-only regimen (median, 56; range, 4 to 152 h) (P = 0.002). Parasite clearance times (overall mean +/- standard deviation, 78 +/- 23 h) were not significantly different between the three treatment groups (P = 0. 98). The cure rates assessed at 28 days of follow-up were 100% for Q(7)C(7) and 98% for Q(7)T(7), whereas the cure rate was 87% for the Q(7)-only regimen (P < or = 0.04). Clindamycin in combination with quinine is a safe and effective treatment for multidrug-resistant P. falciparum malaria. This combination may be of particular value in children and pregnant women, in whom tetracyclines are contraindicated.
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PMID:Therapeutic responses to quinine and clindamycin in multidrug-resistant falciparum malaria. 1095 85

Lincomycin and clindamycin are lincosamide antibiotics used in clinical practice. Both antibiotics are bacteriostatic and inhibit protein synthesis in sensitive bacteria. They may even be bactericidal at the higher concentrations that can be reached in vivo. Clindamycin is usually more active than lincomycin in the treatment of bacterial infections, in particular those caused by anaerobic species; and it can also be used for the treatment of important protozoal diseases, e.g. malaria, most effectively in combination with primaquine. Resistance to lincomycin and clindamycin may be caused by methylation of 23S ribosomal RNA, modification of the antibiotics by specific enzymes or active efflux from the periplasmic space.
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PMID:Lincomycin, clindamycin and their applications. 1476 1

A simple, sensitive, selective and reproducible method based on a reversed-phase chromatography was developed for the determination of clindamycin in human plasma. Clindamycin was separated from the internal standard (phenobarbital) on a Luna C18 column (250 x 4.6 mm, 5 mm particle size: Phenomenex, USA), with retention times of 5.6 and 14.2 minutes, respectively. Ultraviolet detection was set at 210 nm. The mobile phase consisted of a solution of 0.02 M disodiumhydrogenphosphate (pH 2.8) and acetonitrile (76:24 v/v), running through the column at a flow rate of 1.0 ml/min. The chromatographic analysis was operated at 25 degrees C. Sample preparation (1 ml plasma) was done by a single step liquid-liquid extraction with water saturated ethylacetate. Calibration curves in plasma at concentrations of 0.25, 0.5, 1.0, 2.0, 4.0, 8.0 and 16.0 microg/ml were all linear with correlation coefficients better than 0.999. The precision of the method based on within-day repeatability and reproducibility (day-to-day variation) was below 15% (% coefficient of variations: %CV). Good accuracy was observed for both the intra-day and inter-day assays, as indicated by the minimal deviation of mean values found with measured samples from that of the theoretical values (below +/- 15%). Limit of quantification was accepted as 0.07 microg using 1 ml plasma sample. The mean recovery for clindamycin and the internal standard were greater than 95%. The method was free from interference from fosmidomycin, including commonly used drugs, antimalarials and antihelminthics. The method appears to be robust and has been applied to a pharmacokinetic study of clindamycin in a patient with malaria following oral doses of clindamycin at 10 mg/kg body weight given twice daily for 7 days.
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PMID:An alternative high-performance liquid chromatographic method for determination of clindamycin in plasma. 1677 Dec 32

The phosphonohydroxamic acid Fosmidomycin is a drug candidate for the treatment of Malaria, currently in phase II trials in combination with Clindamycin. In order to obtain compounds of higher lipophilicity, we recently synthesized alpha-phenyl substituted Fosmidomycin derivatives which display high antimalarial activity. We now report the synthesis and in vitro antimalarial activity of arylmethyl substituted bis(pivaloyloxymethyl) ester prodrugs of Fosmidomycin and its acetyl analogue FR900098. The 3,4-dichlorobenzyl substituted derivative of Fosmidomycin proved to be about twice as active as the respective Fosmidomycin prodrug, however, less active than the corresponding FR900098 prodrug. Electron donating substituents as well as voluminous substituents led to a significant reduction of activity.
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PMID:Arylmethyl substituted derivatives of Fosmidomycin: synthesis and antimalarial activity. 1705 17


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