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Volume 4, Number 1—March 1998


Proteases of Malaria Parasites: New Targets for Chemotherapy

Philip J. RosenthalComments to Author 
Author affiliation: San Francisco General Hospital and University of California, San Francisco, California, USA

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Table 1

Established antimalarial drugsa

Drug Role Best Feature(s) Limitations
Chloroquine TX of and CP against non- Pf and sensitive Pf parasites Very safe; low cost; long half-life Widespread R
Quinine/quinidine Best TX for Pf malaria; low cost Limited R; rapidly acting Fairly toxic (cinchonism, cardiac)
Amodiaquineb TX of R Pf malaria Low cost Toxicity (bone marrow, liver); R common
Mefloquine CP against R Pf malaria; not approved for TX in United States Relatively little R, though increasing; long half-life Moderately toxic (mostly CNS); high cost; R in SE Asia
Fansidar TX of Pf malaria; no longer recommended for CP Relatively low cost; long half-life Skin toxicity (can be fatal); increasing R
Primaquine Eradication of chronic liver stage Pv, Po malaria Only drug for this indication Hemolysis with G6PD deficiency; increasing R
Proguanilb CP only (often with chloroquine) Low cost; nontoxic R common
Maloprimb CP only (often with chloroquine) Low cost R common; skin rashes
Tetracyclines CP; TX of Pf malaria in combination with quinine Low cost Skin and gastrointestinal toxicity

aTX, therapy; CP, chemoprophylaxis; R, resistance/resistant; Pf, Plasmodium falciparum; Pv, P. vivax; Po, P. ovale; CNS, central nervous system; G6PD, glucose 6-phosphate dehydrogenase.
bNot available in the United States.

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