Dapsone

Publication Title: 
The Journal of Antimicrobial Chemotherapy

The anticryptosporidial activity of four macrolides alone and in combination with other antimicrobial agents was investigated against ten clinical isolates of Cryptosporidium parvum recovered from stools of AIDS patients. The susceptibility tests were performed by inoculation of the protozoa on to cell monolayers and determining the parasite count after 72 h incubation at 37 degrees C.

Author(s): 
Giacometti, A.
Cirioni, O.
Scalise, G.
Publication Title: 
Tropical medicine & international health: TM & IH

The synergistic antifolate combination of chlorproguanil with dapsone (CPG-DDS; LAPDAP) is being developed by a public-private partnership as a low-cost treatment for uncomplicated falciparum malaria. LAPDAP is rapidly eliminated from the body, giving it low selection pressure for drug resistance. Clinical cases with sulphadoxine-pyrimethamine (SP)-resistant infections acquired in Africa have been predicted to be responsive to LAPDAP, and clinical evidence is available to support this.

Author(s): 
Winstanley, P.
Publication Title: 
British Journal of Clinical Pharmacology

The burgeoning problem of malaria in the developing world and the relentless march of drug resistance demand that we continue to seek new chemotherapeutic strategies. Given the enormous expense of developing and marketing new chemical entities, we often rely on an increased understanding of the pharmacology of older drugs and judicious use of drug combinations. Development is being driven primarily by public-private partnerships from academic investigations.

Author(s): 
Edwards, Geoffrey
Biagini, Giancarlo A.
Publication Title: 
Journal of Infection in Developing Countries

BACKGROUND: Malaria infection during pregnancy is a major public health problem. Due to increasing resistance to Chloroquine and Sulphadoxine/Pyrimethamine, the Ugandan national policy on malaria treatment was changed in 2005 to Artemisinin-based combination therapy (ACT) as the first-line treatment for uncomplicated malaria. The policy recommends assessment of safety and efficacy of alternative drugs for treatment of uncomplicated malaria.

Author(s): 
Kaye, Daniel Kabonge
Nshemerirwe, Ruth
Mutyaba, Twaha Serunjogi
Ndeezi, Grace
Publication Title: 
PloS One

The objective of this study was to determine the appropriate dose of artesunate for use in a fixed dose combination therapy with chlorproguanil-dapsone (CPG-DDS) for the treatment of uncomplicated falciparum malaria. METHODS: Open-label clinical trial comparing CPG-DDS alone or with artesunate 4, 2, or 1 mg/kg at medical centers in Blantyre, Malawi and Farafenni, The Gambia. The trial was conducted between June 2002 and February 2005, including 116 adults (median age 27 years) and 107 children (median age 38 months) with acute uncomplicated Plasmodium falciparum malaria.

Author(s): 
Wootton, Daniel G.
Opara, Hyginus
Biagini, Giancarlo A.
Kanjala, Maxwell K.
Duparc, Stephan
Kirby, Paula L.
Woessner, Mary
Neate, Colin
Nyirenda, Maggie
Blencowe, Hannah
Dube-Mbeye, Queen
Kanyok, Thomas
Ward, Stephen
Molyneux, Malcolm
Dunyo, Sam
Winstanley, Peter A.
Publication Title: 
PloS One

BACKGROUND: Artesunate+amodiaquine (AS+AQ) and artemether-lumefantrine (AL) are now the most frequently recommended first line treatments for uncomplicated malaria in Africa. Artesunate+chlorproguanil-dapsone (AS+CD) was a potential alternative for treatment of uncomplicated malaria. A comparison of the efficacy and safety of these three drug combinations was necessary to make evidence based drug treatment policies. METHODS: Five hundred and thirty-four, glucose-6-phosphate dehydrogenase (G6PD) normal children were randomised in blocks of 15 to the AS+AQ, AL or AS+CD groups.

Author(s): 
Owusu-Agyei, Seth
Asante, Kwaku Poku
Owusu, Ruth
Adjuik, Martin
Amenga-Etego, Stephen
Dosoo, David Kwame
Gyapong, John
Greenwood, Brian
Chandramohan, Daniel
Publication Title: 
PloS One

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common inherited human enzyme defect. This deficiency provides some protection from clinical malaria, but it can also cause haemolysis after administration of drugs with oxidant properties. METHODS: The safety of chlorproguanil-dapsone+artesunate (CD+A) and amodiaquine+sulphadoxine-pyrimethamine (AQ+SP) for the treatment of uncomplicated P. falciparum malaria was evaluated according to G6PD deficiency in a secondary analysis of an open-label, randomized clinical trial.

Author(s): 
Fanello, Caterina I.
Karema, Corine
Avellino, Pamela
Bancone, Germana
Uwimana, Aline
Lee, Sue J.
D'Alessandro, Umberto
Modiano, David
Publication Title: 
PloS One

BACKGROUND: Malaria in pregnancy is serious, and drug resistance in Africa is spreading. Drugs have greater risks in pregnancy and determining the safety and efficacy of drugs in pregnancy is therefore a priority. This study set out to determine the efficacy and safety of several antimalarial drugs and combinations in pregnant women with uncomplicated malaria. METHODS: Pregnant women with non-severe, slide proven, falciparum malaria were randomised to one of 4 regimes: sulfadoxine-pyrimethamine [SP]; chlorproguanil-dapsone [CD]; SP+amodiaquine [SP+AQ] or amodiaquine+artesunate [AQ+AS].

Author(s): 
Mutabingwa, Theonest K.
Muze, Kandi
Ord, Rosalynn
Briceño, Marnie
Greenwood, Brian M.
Drakeley, Chris
Whitty, Christopher J. M.
Publication Title: 
PloS One

BACKGROUND: Chlorproguanil-dapsone-artesunate (CDA) was developed as an affordable, simple, fixed-dose artemisinin-based combination therapy for use in Africa. This trial was a randomized parallel-group, double-blind, double-dummy study to compare CDA and artemether-lumefantrine (AL) efficacy in uncomplicated Plasmodium falciparum malaria and further define the CDA safety profile, particularly its hematological safety in glucose-6-phosphate dehydrogenase (G6PD) -deficient patients.

Author(s): 
Premji, Zul
Umeh, Rich E.
Owusu-Agyei, Seth
Esamai, Fabian
Ezedinachi, Emmanuel U.
Oguche, Stephen
Borrmann, Steffen
Sowunmi, Akintunde
Duparc, Stephan
Kirby, Paula L.
Pamba, Allan
Kellam, Lynda
Guiguemdé, Robert
Greenwood, Brian
Ward, Stephen A.
Winstanley, Peter A.
Publication Title: 
Malaria Journal

BACKGROUND: Sulphadoxine-pyrimethamine (SP) is the only single dose therapy for uncomplicated malaria, but there is widespread resistance. At the time of this study, artemether-lumefantrine (AL) and chlorproguanil-dapsone (CPD), both multi-dose regimes, were considered possible alternatives to SP in Malawi. The aim of this study was to investigate the impact of poor adherence on the effectiveness of AL and CPD. METHODS: Children > or =12 months and adults with uncomplicated malaria were randomized to receive AL, CPD or SP.

Author(s): 
Bell, David J.
Wootton, Dan
Mukaka, Mavuto
Montgomery, Jacqui
Kayange, Noel
Chimpeni, Phillips
Hughes, Dyfrig A.
Molyneux, Malcolm E.
Ward, Steve A.
Winstanley, Peter A.
Lalloo, David G.

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