Late dihydroartemisinin-piperaquine treatment failure of P. falciparum malaria attack related to insufficient dosing in an obese patient
M. Parisey,
S. Houze,
J. Bailly,
N. Taudon,
K. Jaffal,
N. Argy,
C. Rouzaud,
B. Mégarbane,
S. Lariven,
Y. Yazdanpanah,
S. Matheron
Affiliations
M. Parisey
Department of Infectious Diseases, Bichat Hospital, AP-HP, Paris, France; Department of Infectious Diseases, Delafontaine Hospital, Saint Denis, France; Corresponding author at: Department of Infectious Diseases, Bichat Hospital, AP-HP, Paris, France.
S. Houze
Laboratoire parasitologie, APHP, Bichat Hospital, F-75018 Paris, France; Centre national de référence sur le paludisme, APHP, Bichat Hospital, F-75018 Paris, France; Université de Paris, MERIT UMR 261, F-75006 Paris, France
J. Bailly
Centre national de référence sur le paludisme, APHP, Bichat Hospital, F-75018 Paris, France; Université de Paris, MERIT UMR 261, F-75006 Paris, France
N. Taudon
Institut de recherche biomédicale des armées, Unité Développements Analytiques et Bioanalyse, 91220 Brétigny-sur-Orge, France
K. Jaffal
Université de Paris, MERIT UMR 261, F-75006 Paris, France; Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Paris, France; INSERM UMRS, 1144 Paris, France
N. Argy
Laboratoire parasitologie, APHP, Bichat Hospital, F-75018 Paris, France; Centre national de référence sur le paludisme, APHP, Bichat Hospital, F-75018 Paris, France; Université de Paris, MERIT UMR 261, F-75006 Paris, France
C. Rouzaud
Department of Infectious Diseases, Bichat Hospital, AP-HP, Paris, France
B. Mégarbane
Université de Paris, MERIT UMR 261, F-75006 Paris, France; Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Paris, France; INSERM UMRS, 1144 Paris, France
S. Lariven
Department of Infectious Diseases, Bichat Hospital, AP-HP, Paris, France
Y. Yazdanpanah
Department of Infectious Diseases, Bichat Hospital, AP-HP, Paris, France; Infection Antimicrobials Modelling Evolution (IAME), UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
S. Matheron
Department of Infectious Diseases, Bichat Hospital, AP-HP, Paris, France; Infection Antimicrobials Modelling Evolution (IAME), UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
We report the case of an obese patient who experienced late failure on day28 of a well-conducted treatment with artesunate, followed by dihydroartemisinin-piperaquine (DHA-PPQ) for a severe P. falciparum malaria attack. The same P. falciparum strain was evidenced at day0 and day28. Genotypic and phenotypic resistance tests could not explain this treatment failure. The low plasma piperaquine concentration at failure may explain the poor elimination of residual parasites.
