Evaluation of Fosmidomycin in Adults with Acute Uncomplicated Plasmodium falciparum Malaria

ABSTRACT

The treatment of malaria is becoming increasingly difficult due to the development of Plasmodium falciparum strains resistant to the commonly used antimalarials. There is thus an urgent need for new, effective, and safe, antimalarial drugs. This study determined the efficacy of fosmidomycin among patients with uncomplicated P. falciparum infection. Fifteen patients were enrolled to receive fosmidomycin 1,200 mg orally every 8 hours for 7 days on an inpatient basis, followed by scheduled outpatient visits on days 14, 21, and 28 post-treatment. Five patients withdrew from the study 1 had an equivocal pregnancy test result, 1 developed signs of severe malaria, 1 withdrew consent, and 2 did not receive the full treatment course. Per-protocol analysis showed a 100% cure rate in the first 7 days, dropping to 22% at 28-day follow-up. No serious adverse effects were observed. The result of this study showed that fosmidomycin cleared parasites well in the first 7 days; however, the recrudescence rate was high during the 28 days’ follow-up period. The drug should be useful in the treatment of acute uncomplicated P. falciparum malaria infection, but combination therapy is needed to reduce recrudescence, thus improving cure rate.