multiple drugs for treatment


For several years, healthcare practitioners have often wondered if the concurrent use of three or more drugs by patients is an effective method for keeping drug resistance at bay if the drugs yield good results when used in combination. The theory has practical consequences, as nearly every malaria-endemic country adopts a single first-line treatment (a combination drug nowadays) as policy. National policies are difficult to change and implement in these relatively poor countries. In addition, good evidence is required to adopt a more complex approach. CDDEP researchers began investigating MFT in 2006 using an evolutionary-epidemiological modeling framework. They compared MFT with single combination drugs and with cycling strategies where therapies are rotated, either on a fixed cycling schedule or when resistance levels or chances of treatment failure become too high. Compared to these alternatives, the analysis predicts that MFT strategies will delay the emergence and slow down the fixation of resistant strains.