Norfloxacin: a new drug in the treatment of falciparum malaria

Article Abstract:

Malaria is an infectious disease caused by an organism called Plasmodium, which is transmitted by bites from infected mosquitoes, or by blood transfusion. Malaria is characterized by chills, fever, sweats, anemia, enlargement of the spleen, and deposition of the pigment melanin in various organs. Although some effective antimalarial agents have been developed, including quinine, chloroquine, primaquine, and mefloquine, their widespread use has stimulated the appearance of resistant strains of Plasmodium. The effectiveness of the fluoroquinolone antibiotic norfloxacin was assessed in treating nine patients with falciparum malaria, a specific type of malaria caused by Plasmodium falciparum. A dose of 0.4 grams of norfloxacin was given by mouth every 12 hours for three days. The antibiotic cured all nine patients, and was not associated with adverse side effects or recurrence of infection within 35 days after the start of drug therapy. The chemical structure of norfloxacin resembles that of some other antimalarial agents, although the link between chemical structure and antimalarial activity is not clear. The fluoroquinolones inhibit the deoxyribonucleic acid (DNA) gyrase, an enzyme involved in the formation of DNA, a molecule that carries the genetic information of the cell. Although this preliminary report shows that norfloxacin is effective against Plasmodium falciparum infection, the number of patients studied was small and further investigation is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Norfloxacin

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Fluoroquinolones for malaria: the newest kid on the block?

Article Abstract:

Malaria is an infectious disease caused by the organism Plasmodium, which is transmitted by bites from infected Anopheles mosquitoes, or by blood transfusion. It is characterized by chills, fever, sweats, anemia, enlargement of the spleen, and deposition of the pigment melanin in various organs. Although several effective antimalarial agents have been developed, including quinine, chloroquine, primaquine, and mefloquine, their widespread use has resulted in the production of resistant strains of Plasmodia. Quinine combined with the antibiotic tetracycline, daily treatment with the antibiotic doxycycline, and a plant product, artemesinin or qinghaosu, are effective against falciparum malaria strains resistant to various antimalarial agents, including chloroquine and mefloquine. A recent study showed that the fluoroquinolone antibiotic norfloxacin was effective in treating falciparum malaria. The chemical structure of norfloxacin resembles that of some types of antimalarial agents, although the relation between chemical structure and antimalarial activity is not clear. The fluoroquinolones inhibit the deoxyribonucleic acid (DNA) gyrase, an enzyme involved in the formation of DNA, a molecule that carries the genetic information of the cell. The use of norfloxacin with regard to the immune function of the patient, as well as its mechanism of action require further investigation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug resistance

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Pefloxacin for falciparum malaria: only modest success

Article Abstract:

Malaria is caused by infection with the parasite Plasmodium falciparum, and has traditionally been treated with the drug chloroquine. In recent years, P. falciparum has been developing significant resistance to chloroquine, prompting researchers to investigate other drugs to treat malaria. Pefloxacin has been found to be effective in treating mice who are infected with the strain of malaria to which they are susceptible. A group of 22 patients with P. falciparum malaria were treated with pefloxacin for three days. An initial response was observed in 16 patients. However, by day 14, parasites reappeared in the blood of seven of these patients. Nine out of the total 22 patients were cured of their disease, suggesting that this drug is effective, but that perhaps the treatment regimen may be inadequate. The use of pefloxacin in combination with chloroquine may be more effective than chloroquine and tetracycline. Further study of pefloxacin at other doses and lengths of treatment is warranted. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Plasmodium falciparum

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