Plasmodium falciparum crossresistance between trimethoprim and pyrimethamine

doi:10.1016/S0140-6736(01)06201-8

The Lancet

Volume 358, Issue 9287, 29 September 2001, Pages 1066-1067

https://doi.org/10.1016/S0140-6736(01)06201-8 Get rights and content

Summary

Trimethoprim-sulfamethoxazole has been recommended as part of the standard package of care for people with HIV and AIDS in Africa. A similar antifolate combination, sulfadoxine-pyrimethamine, is now the first-line antimalarial drug in several of the African countries with the highest rates of HIV infection. We present evidence of Plasmodium falciparum cross-resistance between trimethoprim and pyrimethamine at the molecular level. The impact of trimethoprim-sulfamethoxazole on the efficacy of sulfadoxine-pyrimethamine needs to be assessed urgently, and alternative antimalarial treatment should be considered for people on trimethoprim-sulfamethoxazole prophylaxis.

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Prevailing plasmodium falciparum dihydrofolate reductase 108-asparagine in hodeidah, yemen: A questionable sulfadoxine-pyrimethamine partner within the artemisinin-based combination therapy
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Citation Excerpt :
The role of antibiotics with a similar mechanism of action to antifolates frequently used to treat bacterial infections, such as co-trimoxazole, in selecting for dhfr 108N could not also be ruled out. The selection of dhfr mutations by these antibiotics and their cross-resistance with SP were reported among P. falciparum isolates (Jelinek et al., 1999; Iyer et al., 2001; Kofoed et al., 2004; Khalil et al., 2005). The possible antibiotic-mediated selection of SP resistance-associated mutations is supported by the fact that SP withdrawal from Southeast Asia was not followed by the disappearance of the mutant parasites (Abdul-Ghani et al., 2013a).
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Research LettersPlasmodium falciparum crossresistance between trimethoprim and pyrimethamine

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Research Letters
Plasmodium falciparum crossresistance between trimethoprim and pyrimethamine