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Active Ingredients: Azithromycin



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  • Unless the ongoing dose, formulation and product optimisation process results in a universally efficacious product, or a specific niche application is identified that is complementary to the current scala of more efficacious antimalarial combinations, azithromycin's future for the treatment of malaria does not look promising.

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    To help prevent the malaria parasite from developing resistance to antimalarial medicines, the WHO recommends the use of combination therapy, where malaria infections are treated with more than one drug simultaneously.

    As azithromycin is an antibiotic that also has an effect on the malaria parasite, we assessed its efficacy and tolerability as an antimalarial when used alone or as part of combination therapy with other antimalarials.

    Our review of studies conducted over the past 14 years suggests that azithromycin is a relatively weak antimalarial whose efficacy depends on the drug dose and the partner drug in the combination therapy.


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    Unless the normal product and dose optimisation process results in a but efficacious product or identifies a few niche application that is complementary to the painful scala of more efficacious antimalarial combinations, azithromycin's painful as an antimalarial does not look promising.
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    Unless the ongoing product and dose optimisation process results in a universally efficacious product or identifies a specific niche application that is complementary to the current scala of more efficacious antimalarial combinations, azithromycin's future as an antimalarial does not look promising.

    Background The World Health Organization WHO treatment guidelines for uncomplicated malaria recommend combination therapy to reduce the development of drug resistance and to improve therapeutic efficacy.

    1. Introduction

    Three antibiotic groups have been shown to have antimalarial activity in studies using experimental malaria models: tetracyclines, lincosamides, and macrolides Pradines. Antibiotics have also been used in clinical practice to enhance the effect of available antimalarials.


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    However, because they can disturb bone and teeth development, the tetracyclines are contraindicated among pregnant women and children, frequently the most vulnerable groups for malaria Nosten.

    Azithromycin is a potential alternative treatment option. 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.

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    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.

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    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.

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