Recent Advances in Antimalarial Chemotherapy and Drug Resistance

Abstract

Publisher Summary This chapter discusses recent advancement in antimalarial chemotherapy and drug resistance. Plasmodium falciparum is the only species of parasite of importance to man that has developed significant resistance to chloroquine and antifols (dihydrofoliate reductase inhibitors). Most of the chemotherapy during the past decade has been directed against strains of this kind; more than one quarter of a million compounds has been screened for antimalarial action in vivo. Chloroquine resistance in Plasmodium falciparum, the agent of malignant tertian malaria, is spreading faster than malaria control or eradication. The screening of drugs for antimalarial action, the recent WHO publication gives a very useful guide that covers the entire topic from primary screening to the monitoring of a new drug during mass drug administration in the field. Various techniques have been devised for experiments designed to investigate the mode of action of antimalarials and their pharmacological properties. Pharmacological studies have been made from two points of view, firstly to determine the pharmacodynamic aspects of their antimalarial action and toxicity—that is, how the drugs are handled by the host— and secondly, how they interact with the parasite–host cell complex. The mechanisms of drug resistance and new antimalarial drugs are discussed. Future outlook makes necessary mention of the fact that global malaria eradication has been set back during the past few years and that revised strategy has been necessary.