XXXX Antimalarials: Preserving the "Magic Bullet"

@entity4801 @entity311 @entity17743 @entity507
The @entity17743 are the most effective antimalarial drugs known. They possess a remarkably wide therapeutic index. These agents have been used in traditional Chinese herbal medicine for more than 2,000 years but were not subjected to scientific scrutiny until the 1970s. The first formal clinical trials of the @entity17743 , and the development of methods for their industrial scale production, followed rapidly. A decade later, Chinese scientists shared their findings with the rest of the world; since then, a significant body of international trial evidence has confirmed these drugs to be far superior to any available alternatives. In particular, they have the ability to rapidly kill a broad range of @entity4801 stages at safe concentrations that are consistently achievable via standard dosing regimens. As their half-life is very short, there was also thought to be a low risk of resistance. These discoveries coincided with the appearance and spread of resistance to all the other major classes of antimalarials. As a result, the @entity17743 now form an essential element of recommended first-line antimalarial treatment regimens worldwide. To minimize the risk of @entity507 resistance, they are recommended to be used to treat uncomplicated @entity311 in combination with other antimalarials as @entity507 combination therapies (ACTs). Their rollout has resulted in documented reductions in @entity311 prevalence in a number of African and Asian countries. Unfortunately, there are already worrisome early signs of @entity507 resistance appearing in western Cambodia. If this resistance were to spread, it would be disastrous for @entity311 control efforts worldwide. The enormous challenge for the international community is how to avert this catastrophe and preserve the effectiveness of this antimalarial "magic bullet". Drug Dev Res 71: 12-19, 2010.    2009 Wiley-Liss, Inc.
