Some strains of falciparum malaria have progressed from simple drug resistance to multi-drug resistance (MDR) to extensive drug resistance (XDR).


A resistant strain of Plasmodium falciparum is resistant to one or both of the following:

(1) chloroquine

(2) sulfadoxine-pyrimethamine (SP)


Multi-drug resistance (MDR) is resistance to 3 or more antimalarial compounds of different chemical classes. In addition to chloroquine and SP these may include:

(1) mefloquine

(2) lumefantrine


Some regimens developed to treat MDR:

(1) ACT is artemisinin-based combination therapy. An example is artesunate plus mefloquine.

(2) Coartem is the combination of artemether and lumefantrine.


The emergence of resistance to artemisinin has resulted in the term extensive drug resistance (XDR).


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