Biguanides efficacy

Proguanil is one of the antimalarial drugs most widely used for prophylactic purposes, usually in combination with chloroquine or atovaquone in malaria prophylaxis, and with atovaquone in malaria treatment (SEDA-21, 297). A biguanide, it is rapidly absorbed in standard doses and mainly excreted by the kidneys. Its antimalarial effect is due to its metabolite cycloguanU. However, its metabolism varies individually, and this is reflected in a variable degree of efficacy (SEDA-17, 328). 

The combination of metformin and insulin in Type-II diabetics increases the efficacy of insulin and reduces insulin resistance in obese patients. A considerable reduction in insulin doses has been achieved (Leblanc et al., 1987). Free serum insulin levels have been reduced from 51 to 41 units/ml 1 (Stowers, 1980). On mixed biguanide-insulin treatment, the atherogenic effect of hyperinsulinaemia and the number of hypoglycaemic reactions can be reduced. 

The therapeutic effects of acarbose and biguanides have been compared in Type-II diabetics (Pagano and Cavallo-Perin, 1990) and found to be nearly equally effective. The same was true in studies (by Schwedes et al. (1982), who compared acarbose and metformin in poorly controlled NIDDM, while Schoffling et al. (1982) reported that acarbose was even more effective than metformin. Drost et al. (1982) concluded from their studies, however, that there was no basic difference between the hypoglycaemic effects of acarbose and metformin. Petersen (1982) tested the efficacy of acarbose versus buformin in NIDDM. Acarbose was found to reduce postprandial but not fasting blood glucose levels and to be slightly less effective than buformin. 

Wallace, M.L., 2001. Testing the efficacy of polyhexamethylene biguanide as an antimicrobial treatment for cotton fabric. AATCC Rev. 1, 18-20. 

Kawabata A and Taylor JA, The effect of reactive dyes upon the uptake and antibacterial efficacy of poly(hexamethylene biguanide) on cotton . Carbohydrate Polymers, 67 (3), 2007, pp 375-389. 

Guanidine and guanylguanidine (biguanide) are bases which are stabilized by resonance. They exhibit strong alkaline reaction in aqueous media and form salts with acids. Alkyl derivatives dispose of distinctive antimicrobial efficacy. 

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