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Atovaquone-proguanil versus mefloquine for malaria prophylaxis in nonimmune travelers: results from a randomized, double-blind study.
Clin Infect Dis. 2001 Oct 01; 33(7):1015-21.CI

Abstract

Concerns about the tolerability of mefloquine highlight the need for new drugs to prevent malaria. Atovaquone-proguanil (Malarone; GlaxoSmithKline) was safe and effective for prevention of falciparum malaria in lifelong residents of malaria-endemic countries, but experience in nonimmune people is limited. In a randomized, double-blind study, nonimmune travelers received malaria prophylaxis with atovaquone-proguanil (493 subjects) or mefloquine (483 subjects). Information about adverse events (AEs) and potential episodes of malaria was obtained 7, 28, and 60 days after travel. AEs were reported by an equivalent proportion of subjects who had received atovaquone-proguanil or mefloquine (71.4% versus 67.3%; difference, 4.1%; 95% confidence interval, -1.71 to 9.9). Subjects who received atovaquone-proguanil had fewer treatment-related neuropsychiatric AEs (14% versus 29%; P=.001), fewer AEs of moderate or severe intensity (10% versus 19%; P=.001), and fewer AEs that caused prophylaxis to be discontinued (1.2% versus 5.0%; P=.001), compared with subjects who received melfoquine. No confirmed diagnoses of malaria occurred in either group. Atovaquone-proguanil was better tolerated than was mefloquine, and it was similarly effective for malaria prophylaxis in nonimmune travelers.

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Authors+Show Affiliations

Overbosch D
Harbor Hospital and Institute of Tropical Medicine, Rotterdam, The Netherlands.
Schilthuis H
No affiliation info available
Bienzle U
No affiliation info available
Behrens RH
No affiliation info available
Kain KC
No affiliation info available
Clarke PD
No affiliation info available
Toovey S
No affiliation info available
Knobloch J
No affiliation info available
Nothdurft HD
No affiliation info available
Shaw D
No affiliation info available
Roskell NS
No affiliation info available
Chulay JD
No affiliation info available
Malarone International Study Team
No affiliation info available

MeSH

AdolescentAdultAgedAged, 80 and overAntimalarialsAtovaquoneChildChild, PreschoolDouble-Blind MethodDrug CombinationsFemaleHumansMalariaMaleMefloquineMiddle AgedNaphthoquinonesProguanilTravelTreatment Outcome

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11528574

Clinical Trial Links

Evaluating the Ottawa Malaria Decision Aid

Citation

Overbosch, D, et al. "Atovaquone-proguanil Versus Mefloquine for Malaria Prophylaxis in Nonimmune Travelers: Results From a Randomized, Double-blind Study." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 33, no. 7, 2001, pp. 1015-21.
Overbosch D, Schilthuis H, Bienzle U, et al. Atovaquone-proguanil versus mefloquine for malaria prophylaxis in nonimmune travelers: results from a randomized, double-blind study. Clin Infect Dis. 2001;33(7):1015-21.
Overbosch, D., Schilthuis, H., Bienzle, U., Behrens, R. H., Kain, K. C., Clarke, P. D., Toovey, S., Knobloch, J., Nothdurft, H. D., Shaw, D., Roskell, N. S., & Chulay, J. D. (2001). Atovaquone-proguanil versus mefloquine for malaria prophylaxis in nonimmune travelers: results from a randomized, double-blind study. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 33(7), 1015-21.
Overbosch D, et al. Atovaquone-proguanil Versus Mefloquine for Malaria Prophylaxis in Nonimmune Travelers: Results From a Randomized, Double-blind Study. Clin Infect Dis. 2001 Oct 1;33(7):1015-21. PubMed PMID: 11528574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atovaquone-proguanil versus mefloquine for malaria prophylaxis in nonimmune travelers: results from a randomized, double-blind study. AU - Overbosch,D, AU - Schilthuis,H, AU - Bienzle,U, AU - Behrens,R H, AU - Kain,K C, AU - Clarke,P D, AU - Toovey,S, AU - Knobloch,J, AU - Nothdurft,H D, AU - Shaw,D, AU - Roskell,N S, AU - Chulay,J D, AU - ,, Y1 - 2001/09/05/ PY - 2001/01/24/received PY - 2001/03/27/revised PY - 2001/8/31/pubmed PY - 2002/1/5/medline PY - 2001/8/31/entrez SP - 1015 EP - 21 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 33 IS - 7 N2 - Concerns about the tolerability of mefloquine highlight the need for new drugs to prevent malaria. Atovaquone-proguanil (Malarone; GlaxoSmithKline) was safe and effective for prevention of falciparum malaria in lifelong residents of malaria-endemic countries, but experience in nonimmune people is limited. In a randomized, double-blind study, nonimmune travelers received malaria prophylaxis with atovaquone-proguanil (493 subjects) or mefloquine (483 subjects). Information about adverse events (AEs) and potential episodes of malaria was obtained 7, 28, and 60 days after travel. AEs were reported by an equivalent proportion of subjects who had received atovaquone-proguanil or mefloquine (71.4% versus 67.3%; difference, 4.1%; 95% confidence interval, -1.71 to 9.9). Subjects who received atovaquone-proguanil had fewer treatment-related neuropsychiatric AEs (14% versus 29%; P=.001), fewer AEs of moderate or severe intensity (10% versus 19%; P=.001), and fewer AEs that caused prophylaxis to be discontinued (1.2% versus 5.0%; P=.001), compared with subjects who received melfoquine. No confirmed diagnoses of malaria occurred in either group. Atovaquone-proguanil was better tolerated than was mefloquine, and it was similarly effective for malaria prophylaxis in nonimmune travelers. SN - 1058-4838 UR - https://www.unboundmedicine.com/medline/citation/11528574/Atovaquone_proguanil_versus_mefloquine_for_malaria_prophylaxis_in_nonimmune_travelers:_results_from_a_randomized_double_blind_study_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/322694 DB - PRIME DP - Unbound Medicine ER -