Clindamycin antimalarial

Some antibiotics, such as the tetracyclines, tetracycline (7), doxycycline (78), and minocycline (17), chloramphenicol (79), and clindamycin (23) have modest antimalarial properties, but are slow-acting. 

Clindamycin (see Chapter 44) is slowly active against erythrocytic schizonts and can be used after treatment courses of quinine, quinidine, or artesunate in those for whom doxycycline is not recommended, such as children and pregnant women. Azithromycin (see Chapter 44) also has antimalarial activity and is now under study as an alternative chemoprophylactic drug. Antimalarial activity of fluoroquinolones has been demonstrated, but efficacy for the therapy or chemoprophylaxis of malaria has been suboptimal. 

Corticosteroids and a combination of clindamycin (antibiotic) and primaquine (an antimalarial) have also been used to treat pneumonia. 

Toxoplasmosis Lymph nodes many organs and tissues Pyrimethamine-sulfadiazine [see antimalarial drugs] other antibacterials [clindamycin] Trimethoprim-sulfamethoxazole another agent [azithromycin, clarithromycin, atovaquone, or dapsone]... 

This section consists of antiprotozoal drugs. Note that antimalarials are also antiprotozoals but have been described in a separate section Antibiotics with antiprotozoal activity are not included in this chapter. These include clindamycin, co-trimoxazole/trimethoprim, dapsone, doxycydine and metronidazole ... 

Similar structure activity relationships were found in the 4,-alkyl analogues of clindamycin (87). The de - A- me thdclindamycin intermediates including de- /V-methylclindamycin itself, but unlike de- IV-methyllincomycin, are also highly active antibacterially. In addition, they are active in vivo as antimalarial agents (66—68). 

Quinine sulfate is the standard drug for oral treatment of acute attacks of malaria due to chloroquine-resistant P falciparum. It should be used in combination with one or more other antimalarial drugs such as doxycycUne, clindamycin, or pyrimethamine plus sulfadiazine. The answer is (E). 

C17H31CIN2O5S 410.961 Antimalarial agent. Active against aerobic gram-positive bacteria. Used to treat bovine mastitis. Cryst. (H2O). Log P 0.19 (uncertain value) (calc). Clindamycin analogue. 

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