A Standardized Culture Medium for Comparative Drug Efficacy Evaluation Across Plasmodium and Babesia Species

The discovery of broad-spectrum antiparasitic agents relies on the ability to evaluate drug efficacy under harmonized in vitro conditions across related species. However, current drug screening pipelines for intraerythrocytic parasites are constrained by the use of species-specific media with distinct nutrient compositions and serum sources, which hinder direct comparison of compound potency. To address this gap, we describe a unified erythrocytic culture system based on DMEM/F12 supplemented with 20% fetal bovine serum (DFS20), which supports robust asexual growth of multiple Plasmodium falciparum strains (3D7, Dd2, HB3, V1/S), Babesia duncani, Babesia divergens (Rouen 87), and Babesia MO1. Parasite proliferation and morphology in DFS20 are comparable to those observed in established species-specific media such as RPMI-1640 for P. falciparum and B. divergens and HL-1/Claycomb/DMEM/F12/SFM for B. duncani, while eliminating reliance on undefined or discontinued proprietary components. Importantly, this standardized medium enables cross-species growth inhibition assays for direct comparison of drug efficacy under identical conditions. Using this platform, we recently screened dihydrotriazines and biguanides targeting the conserved DHFR-TS enzymes and identified potent antifolate candidates with broad-spectrum activity against Babesia and Plasmodium species. For B. duncani, which is uniquely supported by both a continuous in vitro human erythrocyte culture system and a lethal in vivo mouse infection model, integration with the in-culture and in-mouse (ICIM) pipeline enables systematic validation of pharmacodynamics, pharmacokinetics, resistance, and toxicity. This unified DFS20-based system establishes a scalable and reproducible protocol for harmonized drug efficacy evaluation across intraerythrocytic parasites and provides a foundation for the development and prioritization of pan-antiparasitic therapies. Key features • Common culture medium (CCM): DFS20 supports consistent Babesia and Plasmodium growth, enabling standardized, reproducible drug screening across intraerythrocytic protozoan parasites. • Scalable antiparasitic drug screening: SYBR Green I-based in vitro assay adaptable to low-, medium-, or high-throughput compound testing in both drug-sensitive and drug-resistant strains. • Unified red blood cell-based platform that may accelerate efforts to culture challenging or unculturable parasites, thereby expanding opportunities for drug discovery and mechanistic studies.