Intermittent preventive therapy for malaria in pregnancy: is sulfadoxine-pyrimethamine the right drug?

Pregnant women are at particularly high risk for morbidity and mortality from malaria, and pregnancy can markedly affect drug pharmacokinetics, yet the pharmacokinetics of antimalarial drugs in pregnancy has been little studied. An important malaria-control measure in Africa is intermittent preventive therapy (IPT) with sulfadoxine-pyrimethamine (SP) during pregnancy. We discuss IPT with SP in light of several concerns and highlight recent findings from a pharmacokinetic study of SP in this population.