Insights into the pharmacokinetic interactions between antimicrobial and antimalarial drugs following concurrent administration

Background: The co-administration of different drugs is imperative to achieve a desired therapeutic objective or treat coexisting diseases. For example, the concurrent use of antimicrobial and antimalarial drugs is common in the tropics because malaria is frequently associated with other infections such as those of the respiratory tract, urinary tract, or ear, sexually transmitted infections (STIs), and diarrhea, among other infections. Although numerous benefits can be derived from co-administration of different drugs, the expected therapeutic outcome is sometimes affected by drug-drug interactions.

Objective: The study of antimicrobial and antimalarial drug interactions is of great significance to both treatment and research. It is therefore worrying that the analysis of drug-interaction data is often inadequate, leading in some cases to false conclusions about synergism or antagonism. This review aimed to discuss recent findings on antimicrobial and antimalarial drug-drug interactions and some pitfalls in their analysis and interpretation.

Methods: Important literature databases such as Elsevier, IEEExplore, Pubmed, Scopus, Web of Science, Google Scholar, ProQuest, ScienceDirect, and BioMed Central were selected based on the quality, extant content, and broad area of the discipline. The specific keywords related to the study were identified and used for the study purposely to identify related works.

Results: Co-administration of two or more drugs is considered rational when trying to achieve a desired therapeutic objective or treat co-morbidities but the possibility of drug-drug interactions could offset these benefits by bringing about sub-therapeutic drug concentrations that could ultimately lead to treatment failure.

Conclusion: Patients, physicians, pharmacists, and other healthcare providers may be unaware of the possible interactions between antibiotics and antimalarials as well as the mechanisms involved. It is therefore common practice to co-administer antimalarial and antibiotic drugs. Caution is required with the co-administration of these medicines. It is also of public health concern, as the interactions can contribute towards observed antibiotic resistance and treatment failure being experienced in recommended antibiotic treatment regimens.