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Antibiotic-based combination therapy fosmidomycin-artesunate-clindamycin for the concurrent treatment of severe malaria and bacterial blood stream infections in African children

Objective

Severe malaria is a major cause of preventable morbidity and mortality in endemic regions. 76% of all malaria deaths occur in children <5 years in SSA. While severe malaria constitutes a medical emergency, about one third of children diagnosed with severe malaria suffer from another life-threatening infection, most commonly systemic bacterial infections. Diagnostic differentiation is often not possible in resource limited settings. Ideally, empiric treatment for both aetiologies is warranted. However, often enough either antimalarial or antibiotic therapy is administered, putting the patient at an increased risk of death. Additionally, artemisinin partial resistant Plasmodium isolates constitute an increasing therapeutic challenge for currently recommended artesunate monotherapy. Finally, a high proportion of bacterial isolates with resistance against commonly used antibiotics poses a similar therapeutic challenge.
To overcome the 1) lack of adequate initial coverage of antimalarial and antibacterial pathogens, 2) increase of artemisinin partial resistant Plasmodium, and 3)high incidence of antimicrobial drug-resistant bacterial pathogens, we develop an antibiotic-based combination therapy with fosmidomycin-artesunate-clindamycin (FACT) for the simultaneous treatment of severe malaria and bacterial bloodstream infections. FACT includes parenteral artesunate, the currently recommended treatment of severe malaria, coverage of gram-positive and anaerobic bacteria by clindamycin and gram-negative bacteria by fosmidomycin. Clindamycin and fosmidomycin also exert proven synergistic antimalarial activity even in artemisinin resistant isolates. Matching pharmacokinetic parameters and independent modes of action provide further protection against selection for antimalarial drug resistance.
Based on previous clinical trials, this project targets the late clinical development of FACT in a Phase II and Phase III clinical trial for subsequent implementation in health services.

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HORIZON-JU-RIA - HORIZON JU Research and Innovation Actions

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Call for proposal

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(opens in new window) HORIZON-JU-GH-EDCTP3-2025-01-two-stage

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Coordinator

BERNHARD-NOCHT-INSTITUT FUER TROPENMEDIZIN
Net EU contribution

Net EU financial contribution. The sum of money that the participant receives, deducted by the EU contribution to its linked third party. It considers the distribution of the EU financial contribution between direct beneficiaries of the project and other types of participants, like third-party participants.

€ 2 495 250,00
Address
BERNHARD NOCHT STRASSE 74
20359 Hamburg
Germany

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Region
Hamburg Hamburg Hamburg
Activity type
Research Organisations
Links
Total cost

The total costs incurred by this organisation to participate in the project, including direct and indirect costs. This amount is a subset of the overall project budget.

€ 4 049 375,00

Participants (8)

Partners (1)