Table 1|.
Current antimalarial drugs and associated resistance markers
| Chemical class | Common name | Targeted parasite stage | Genetic marker for drug resistance |
|
|---|---|---|---|---|
| Plasmodium falciparum | Plasmodium vivax | |||
| Sesquiterpene lactone endoperoxides | Artemisinin* | All parasite stages | pfkelch13 (REF. 18) | Unknown |
| Artesunate*‡ | All parasite stages | pfkelch13 (REF. 18) | Unknown | |
| Artemether*‡ | All parasite stages | pfkelch13 (REF. 18) | Unknown | |
| Dihydroartemisinin*‡ | All parasite stages | pfkelch13 (REF. 18) | Unknown | |
| 4-Aminoquinolines | Chloroquineठ| Blood stages (trophozoite and schizont) | pfcrt17,26 | pvmdr1 (REF. 81) |
| Amodiaquine*‡ | Blood stages (trophozoite and schizont) | pfcrt, pfmdr1 (REF. 129) | Unknown | |
| Piperaquine*‡ | Blood stages (trophozoite and schizont) | pfplm2 (REFS 37,38), pfcrt55,130 | Unknown | |
| Pyronaridine | Blood stages (ring, trophozoite and schizont) | pfcrt131 | Unknown | |
| Naphthoquine* | Blood stages (trophozoite and schizont) | Unknown | Unknown | |
| Amino alcohols | Quinine§ | Blood stages (trophozoite and stages I to III gametocytes) | pfcrt, pfmdr1 (REFS 51,132) | Unknown |
| Mefloquine* | Blood stages (trophozoite and schizont) | pfmdr1 (REFS 133–135) | pvmdr1 (REFS 81,82) | |
| Lumefantrine*‡ | Blood stages (trophozoite and schizont) | pfcrt, pfmdr1 (REFS 132,136) | Unknown | |
| Halofantrine§ | Blood stages (trophozoite and schizont) | pfcrt, pfmdr1 (REF. 133) | Unknown | |
| 8-Aminoquinoline | Primaquine*‡ | Blood (gametocyte) and liver (schizont) forms | Unknown | Unknown |
| Antifolates | Pyrimethamine* | Blood and liver schizont and mosquito stage (oocysts) | pfdhfr137 | pvdhfr83 |
| Sulfadoxine* | Blood and liver schizont | pfdhps137 | pvdhps83,138 | |
| Proguanil* | Blood stages (schizont and gametocyte) and liver schizont | pfdhfr139 | Unknown | |
| Naphthoquinone | Atovaquone§ | Blood stages (schizont and gametocyte) and liver schizont | pfcytb140 | Unknown |
| Antibiotics | Clindamycin§ | Blood stages | Apicoplast target57 | Unknown |
| Doxycycline§ | Blood stages | Apicoplast target57 | Unknown | |
| Tetracycline§ | Blood stages | Apicoplast target57 | Unknown | |
crt, chloroquine-resistance transporter; cytb, cytochrome b; dhfr, dihydrofolate reductase; dhps, dihydropteroate synthase; mdr1, multidrug resistance protein; pf, Plasmodium falciparum gene; pv, Plasmodium vivax gene; pfkelch13, P. falciparum Kelch 13; plm2, plasmepsin 2.
*
Drug used in artemisinin-based combination therapy.
‡
Antimalarial drug used alone or in combination for the treatment of P. vivax malaria.
§
Antimalarial drug used alone or in combination with molecules other than artemisinin derivatives.