Whether azithromycin acts on the apicoplast translation machinery was addressed by mapping resistance to a specific ribosomal protein, establishing rpl4 as part of the drug's target.
Evidence In vitro resistance selection with Sanger sequencing of resistant P. falciparum lines plus molecular modeling of mutant PfRpl4 with azithromycin
- No mutagenesis complementation or in vitro reconstitution confirms G76V is causative for resistance
- The modeled altered L75 orientation is not experimentally validated by structure
- Findings are in P. falciparum; the P. berghei ortholog PBANKA_API00430 was not directly tested