TY - JOUR
T1 - In vitro interaction of dihydroartemisin and lumefantrine in clinical field isolates from Bangladesh
AU - Thriemer, Kamala
AU - Ali Khan, Wasif
AU - Starzengruber, Peter
AU - Haque, Rashidul
AU - Vossen, Matthias G.
AU - Marma, Aung Swi Prue
AU - Akther, Selim
AU - Fukuda, Mark
AU - Noedl, Harald
PY - 2007/11/1
Y1 - 2007/11/1
N2 - The combination of artemether and lumefantrine was introduced in 2005 as the official first line therapy for uncomplicated falciparum malaria in Bangladesh. Fresh P. falciparum samples from patients with acute uncomplicated falciparum malaria who presented to the field site at the Bandarban Sadar Hospital in Bangladesh were tested in checkerboard in vitro drug sensitivity assays to assess the interaction between dihydroartemisinin (DHA) and lumefantrine (LUM). Clearly synergistic interactions with an overall mean FIC50 of 0.52 and individual mean FICs between 0.26 and 0.85 were found. Lowest FICs were 0.41, 0.18, 0.22, 0.15 and 0.11 at different combination ratios. The optimal combination ratio of the drug combination indicated by the lowest mean FIC average was found to be 1:150 DHA:LUM. Although activity correlations between DHA and lumefantrine were significant, indicating possible cross sensitivity patterns, our data confirm that artemether-lumefantrine is a highly synergistic drug combination.
AB - The combination of artemether and lumefantrine was introduced in 2005 as the official first line therapy for uncomplicated falciparum malaria in Bangladesh. Fresh P. falciparum samples from patients with acute uncomplicated falciparum malaria who presented to the field site at the Bandarban Sadar Hospital in Bangladesh were tested in checkerboard in vitro drug sensitivity assays to assess the interaction between dihydroartemisinin (DHA) and lumefantrine (LUM). Clearly synergistic interactions with an overall mean FIC50 of 0.52 and individual mean FICs between 0.26 and 0.85 were found. Lowest FICs were 0.41, 0.18, 0.22, 0.15 and 0.11 at different combination ratios. The optimal combination ratio of the drug combination indicated by the lowest mean FIC average was found to be 1:150 DHA:LUM. Although activity correlations between DHA and lumefantrine were significant, indicating possible cross sensitivity patterns, our data confirm that artemether-lumefantrine is a highly synergistic drug combination.
KW - Artemisinin
KW - Bangladesh
KW - Lumefantrine
KW - Malaria
KW - Plasmodium falciparum
UR - http://www.scopus.com/inward/record.url?scp=36048994912&partnerID=8YFLogxK
U2 - 10.1007/s00508-007-0862-8
DO - 10.1007/s00508-007-0862-8
M3 - Article
C2 - 17987361
AN - SCOPUS:36048994912
SN - 0043-5325
VL - 119
SP - 67
EP - 70
JO - Wiener Klinische Wochenschrift
JF - Wiener Klinische Wochenschrift
IS - SUPPL. 3
ER -