Active Ingredients: Azithromycin
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Azithromycin can treat a broad spectrum of bacterial infections; it has an attractive safety profile and could be an option for use in pregnancy, where the currently available arsenal of effective and safe antimalarials is limited Nosten.
Studies of the efficacy of azithromycin in the treatment of uncomplicated malaria in experimental and animal models have shown that azithromycin is a relatively weak antimalarial with a slow parasite clearance rate.
The treatment dose, duration of therapy, and antimalarial partner drug are reported to be important determinants of efficacy Andersen 1995; Biswas; Gingras 1992; Gingras 1993; Neerja; Noedl; Ohrt; Puri; Yeo 1995.
In this review, we aim to summarize the available data from randomized controlled trials to assess the usefulness of azithromycin for the treatment of uncomplicated malaria and to identify its potential niche among the available antimalarial drugs.
Objectives To compare the efficacy and safety of azithromycin, alone or in combination with other antimalarial drugs, with alternative antimalarial drugs for treating uncomplicated malaria caused by Plasmodium falciparum or Plasmodium vivax.
Methods Criteria for considering studies for this review Types of studies Types of participants Children and adults presenting with uncomplicated malaria P.
Types of interventions Interventions Azithromycin alone, combined with another antimalarial drug, or combined with a placebo.
Control Other antimalarial drug used alone, combined with other antimalarial drugs, or combined with a placebo. Azithromycin alone if the intervention is azithromycin combined with another antimalarial drug. Azithromycin combined with another antimalarial drug if different combinations or doses of azithromycin have been used.
Types of outcome measures Primary Treatment failure by day 28 unadjusted for new infections, defined as parasitological or clinical evidence of treatment failure between the start of treatment and day 28.
This is equivalent to total failure defined in the current WHO guidelines Bloland and includes new infections. Secondary Treatment failure by day 28 corrected for new infections confirmed by polymerase chain reaction PCR, defined as parasitological or clinical evidence of treatment failure between the start of treatment and day 28.
Fever clearance time. Presence of gametocytes on day 7, 14 or 28. Morbidity other than clinical malaria eg diarrhoea, respiratory tract infections up to 28 days.
Adverse events Serious adverse events defined as fatal, life threatening, or those that require hospitalisation.
Other adverse events. Search methods for identification of studies We attempted to identify all relevant trials regardless of language or publication status published, unpublished, in press, and in progress.
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