# \[e-drug\] Lancet: Antimalarial combinations **URL:** \ **Category:** e-drug\ **Created:** [July 20, 2004, 6:40am UTC](https://talk.edrugplus.org/t/e-drug-lancet-antimalarial-combinations/20152 "2004-07-20T06:40:25Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![E-drug](https://avatars.discourse-cdn.com/v4/letter/e/ecd19e/32.png) [@E-drug](https://talk.edrugplus.org/u/E-drug)\ **Post date:** [July 20, 2004, 6:40am UTC](https://talk.edrugplus.org/t/e-drug-lancet-antimalarial-combinations/20152/1 "2004-07-20T06:40:25Z")
E-drug: Lancet: Antimalarial combinations --------------------------------------------- Antimalarial combinations Peter Gottfried Kremsner, Sanjeev Krishna Lancet 2004; 364: 285-94 [http://www.thelancet.com/journal/vol364/iss9430/full/llan.364.9430.review\_and\_opinion.30244.1](http://www.thelancet.com/journal/vol364/iss9430/full/llan.364.9430.review_and_opinion.30244.1) [Repair long URL] Multidrug resistance has rendered monotherapy for malaria useless in most parts of the world, and has also compromised the usefulness of many of the available combination chemotherapies. New antimalarial regimens are, therefore, urgently needed. We review the various antimalarial combinations that can be used to treat otherwise drug resistant disease, and discuss what defines an ideal antimalarial combination regimen. This long article discuss the rationale for combinations of antimalarials, their roles and their comparative efficacy. Combinations discussed in detail are Artemisinin-containing regimens Sulfadoxine-pyrimethamine Sulfadoxine-pyrimethamine+chloroquine Sulfadoxine-pyrimethamine+amodiaquine Sulfadoxine-pyrimethamine+quinine Sulfadoxine-pyrimethamine-mefloquine Atovaquone-proguanil Chlorproguanil-dapsone Quinine+tetracycline Quinine+clindamycin Artesunate+amodiaquine Artesunate+sulfadoxine-pyrimethamine Artemether-lumefantrine Artesunate+mefloquine The authors conclude The future Multidrug resistance in parasites has forced the use of combination antimalarial regimens. The need for effective treatments has thrown together antimalarial combinations that have often worked better than monotherapies, though sometimes only temporarily. However, we are still far from discovery of an ideal regimen. The best options available now include: mefloquine+ artesunate, which works well in Thailand, although little is known about how this combination translates to high transmission areas; and clindamycin+quinine, which is effective in non-immune individuals, suggesting that clindamycin+artesunate should also be studied. Dihydroartemisinin-piperaquine and fosmidomycin-clindamycin are promising treatment candidates. Until better regimens become available there are enormous demands on policy makers to choose between existing combinations, many of which have not been sufficiently studied for informed judgments to be made. -- -- To send a message to E-Drug, write to: e-drug@healthnet.org To subscribe or unsubscribe, write to: majordomo@healthnet.org in the body of the message type: subscribe e-drug OR unsubscribe e-drug To contact a person, send a message to: e-drug-help@healthnet.org Information and archives: [http://www.essentialdrugs.org/edrug](http://www.essentialdrugs.org/edrug)