Patient was given chioroquine and doxycycline for 7 days. Patients fever decreases in 4 days, but, peripheral smear showed occasional gametocytes of plasmodium falciparum. This type of drug resistance is
High-Yield Explanation
R2 is high grade resistance i.e. reduction of parasitemia by more than 75% at 48 hours of completing treatment but failure to clear the organism within 7 days. Types of Drug Resistance : In defining criteria for resistance to the aminoquinoline antimalarial drugs. WHO has described three grades of resistance following treatment (Low grade) R1 : Recrudescence of infection between 7 and 28 days of completing treatment following initial resolution of symptoms and parasite clearance. (High grade) R2 : Reduction of parasitaemia by > 75% at 48 hours but failure to clear parasites within 7 days. R3 : Parasitaemia does not fall by >75% within 48 hours. Reference: Ghai essential pediatrics 9 th edition Page 256