Gaillard Tiphaine, Briolant Sébastien, Madamet Marylin, Pradines Bruno
Fédération des Laboratoires, Hôpital d'Instruction des Armées Desgenettes, Lyon, France.
Unité de Parasitologie et d'Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, HIA Laveran, Boulevard Laveran, 13013, Marseille, France.
Malar J. 2017 Apr 13;16(1):148. doi: 10.1186/s12936-017-1797-9.
Anti-malarial drug resistance to chloroquine and sulfadoxine-pyrimethamine has spread from Southeast Asia to Africa. Furthermore, the recent emergence of resistance to artemisinin-based combination therapy (ACT) in Southeast Asia highlights the need to identify new anti-malarial drugs. Doxycycline is recommended for malaria chemoprophylaxis for travel in endemic areas, or in combination with the use of quinine for malaria treatment when ACT is unavailable or when the treatment of severe malaria with artesunate fails. However, doxycycline is not used in young children under 8 years of age due to its contraindication due to the risk of yellow tooth discolouration and dental enamel hypoplasia. Doxycycline was developed after tetracycline and was labelled with the same side-effects as the earlier tetracyclines. However, recent studies report little or no effects of doxycycline on tooth staining or dental enamel hypoplasia in children under 8 years of age. In the United States, the Centers for Disease Control and Prevention have recommended the use of doxycycline for the treatment of acute and chronic Q fever and tick-borne rickettsial diseases in young children. It is time to rehabilitate doxycycline and to recommend it for malaria treatment in children under 8 years of age.
抗疟药物对氯喹和磺胺多辛-乙胺嘧啶的耐药性已从东南亚蔓延至非洲。此外，东南亚近期出现的对青蒿素联合疗法（ACT）的耐药性凸显了识别新型抗疟药物的必要性。强力霉素被推荐用于流行地区旅行时的疟疾化学预防，或在无法获得ACT或青蒿琥酯治疗重症疟疾失败时，与奎宁联合用于疟疾治疗。然而，由于存在导致牙齿变黄和牙釉质发育不全的风险，8岁以下幼儿禁用强力霉素。强力霉素是在四环素之后研发的，其标签上标注的副作用与早期四环素相同。然而，最近的研究报告称，强力霉素对8岁以下儿童的牙齿染色或牙釉质发育不全几乎没有影响。在美国，疾病控制与预防中心已推荐使用强力霉素治疗幼儿的急性和慢性Q热以及蜱传立克次体病。现在是时候恢复强力霉素的使用并推荐其用于8岁以下儿童的疟疾治疗了。
