Journal article

Optimal Antimalarial Dose Regimens for Sulfadoxine-Pyrimethamine with or without Azithromycin in Pregnancy Based on Population Pharmacokinetic Modeling

Sam Salman, Francisca Baiwog, Madhu Page-Sharp, Susan Griffin, Harin A Karunajeewa, Ivo Mueller, Stephen J Rogerson, Peter M Siba, Kenneth F Ilett, Timothy ME Davis

Antimicrobial Agents and Chemotherapy | AMER SOC MICROBIOLOGY | Published : 2017


Optimal dosing of sulfadoxine-pyrimethamine (SP) as intermittent preventive treatment in pregnancy remains to be established, particularly when coadministered with azithromycin (AZI). To further characterize SP pharmacokinetics in pregnancy, plasma concentration-time data from 45 nonpregnant and 45 pregnant women treated with SP-AZI (n = 15 in each group) and SP-chloroquine (n = 30 in each group) were analyzed. Population nonlinear mixed-effect pharmacokinetic models were developed for pyrimethamine (PYR), sulfadoxine (SDOX), and N-acetylsulfadoxine (the SDOX metabolite NASDOX), and potential covariates were included. Pregnancy increased the relative clearance (CL/F) of PYR, SDOX, and NASDOX..

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Awarded by National Health and Medical Research Council of Australia

Funding Acknowledgements

This study was funded by the National Health and Medical Research Council of Australia (grant 458555) with support and endorsement from the MiP consortium, which is funded through a grant from the Bill and Melinda Gates Foundation to the Liverpool School of Tropical Medicine. H.K. is supported by an NHMRC Career Development Fellowship, and T.M.E.D. is supported by an NHMRC Practitioner Fellowship.