Antimalarial drug resistance: a review of the biology and strategies to delay emergence and spread.

TitleAntimalarial drug resistance: a review of the biology and strategies to delay emergence and spread.
Publication TypeJournal Article
Year of Publication2013
AuthorsKlein EY
JournalInt J Antimicrob Agents
Volume41
Issue4
Pagination311-7
Date Published2013 Apr
ISSN1872-7913
KeywordsAnimals, Antimalarials, Artemisinins, Drug Resistance, Humans, Malaria, Falciparum, Mutation, Parasitic Sensitivity Tests, Plasmodium falciparum
Abstract

The emergence of resistance to former first-line antimalarial drugs has been an unmitigated disaster. In recent years, artemisinin class drugs have become standard and they are considered an essential tool for helping to eradicate the disease. However, their ability to reduce morbidity and mortality and to slow transmission requires the maintenance of effectiveness. Recently, an artemisinin delayed-clearance phenotype was described. This is believed to be the precursor to resistance and threatens local elimination and global eradication plans. Understanding how resistance emerges and spreads is important for developing strategies to contain its spread. Resistance is the result of two processes: (i) drug selection of resistant parasites; and (ii) the spread of resistance. In this review, we examine the factors that lead to both drug selection and the spread of resistance. We then examine strategies for controlling the spread of resistance, pointing out the complexities and deficiencies in predicting how resistance will spread.

DOI10.1016/j.ijantimicag.2012.12.007
Alternate JournalInt. J. Antimicrob. Agents
PubMed ID23394809
PubMed Central IDPMC3610176
Grant ListU01 GM070708 / GM / NIGMS NIH HHS / United States
U01GM070708 / GM / NIGMS NIH HHS / United States
U54 GM088491 / GM / NIGMS NIH HHS / United States
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