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Treatment of uncomplicated multidrug-resistant falciparum malaria with artesunate-atovaquone-proguanil.
Clin Infect Dis. 2002 Dec 15; 35(12):1498-504.CI

Abstract

In an open-label trial carried out on the northwest border of Thailand, 1596 patients with uncomplicated multidrug-resistant falciparum malaria were randomly assigned to receive atovaquone-proguanil, atovaquone-proguanil-artesunate, or artesunate-mefloquine and were followed up for 42 days. All 3 regimens were highly effective and well tolerated. Fever duration and parasite clearance times were significantly shorter among patients who received artesunate (P<.001). Polymerase chain reaction genotyping confirmed that recrudescence occurred in 13 patients who received artesunate-mefloquine (2.4%), 5 who received atovaquone-proguanil-artesunate (0.9%), and 15 who received atovaquone-proguanil (2.8%). Adding artesunate to atovaquone-proguanil reduced the risk of failure 3-fold (95% confidence interval [CI], 1.1-8.2) and subsequent gametocyte carriage 21-fold (95% CI, 14-30). Gastrointestinal complaints in the first 48 h after initiation of treatment were more common among artesunate recipients, but after day 2, dizziness, sleep disturbance, nausea, vomiting, and anorexia were more common among mefloquine recipients (P< or =.014). Artesunate-atovaquone-proguanil is a highly effective and well-tolerated treatment for multidrug-resistant falciparum malaria.

Authors+Show Affiliations

Shoklo Malaria Research Unit, Mae Sot, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12471569

Citation

van Vugt, Michèle, et al. "Treatment of Uncomplicated Multidrug-resistant Falciparum Malaria With Artesunate-atovaquone-proguanil." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 35, no. 12, 2002, pp. 1498-504.
van Vugt M, Leonardi E, Phaipun L, et al. Treatment of uncomplicated multidrug-resistant falciparum malaria with artesunate-atovaquone-proguanil. Clin Infect Dis. 2002;35(12):1498-504.
van Vugt, M., Leonardi, E., Phaipun, L., Slight, T., Thway, K. L., McGready, R., Brockman, A., Villegas, L., Looareesuwan, S., White, N. J., & Nosten, F. (2002). Treatment of uncomplicated multidrug-resistant falciparum malaria with artesunate-atovaquone-proguanil. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 35(12), 1498-504.
van Vugt M, et al. Treatment of Uncomplicated Multidrug-resistant Falciparum Malaria With Artesunate-atovaquone-proguanil. Clin Infect Dis. 2002 Dec 15;35(12):1498-504. PubMed PMID: 12471569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of uncomplicated multidrug-resistant falciparum malaria with artesunate-atovaquone-proguanil. AU - van Vugt,Michèle, AU - Leonardi,Elisabetta, AU - Phaipun,Lucy, AU - Slight,Thra, AU - Thway,Kyaw Lay, AU - McGready,Rose, AU - Brockman,Alan, AU - Villegas,Leopoldo, AU - Looareesuwan,Sornchai, AU - White,Nicholas J, AU - Nosten,François, Y1 - 2002/12/03/ PY - 2002/06/28/received PY - 2002/09/12/revised PY - 2002/12/10/pubmed PY - 2002/12/18/medline PY - 2002/12/10/entrez SP - 1498 EP - 504 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 35 IS - 12 N2 - In an open-label trial carried out on the northwest border of Thailand, 1596 patients with uncomplicated multidrug-resistant falciparum malaria were randomly assigned to receive atovaquone-proguanil, atovaquone-proguanil-artesunate, or artesunate-mefloquine and were followed up for 42 days. All 3 regimens were highly effective and well tolerated. Fever duration and parasite clearance times were significantly shorter among patients who received artesunate (P<.001). Polymerase chain reaction genotyping confirmed that recrudescence occurred in 13 patients who received artesunate-mefloquine (2.4%), 5 who received atovaquone-proguanil-artesunate (0.9%), and 15 who received atovaquone-proguanil (2.8%). Adding artesunate to atovaquone-proguanil reduced the risk of failure 3-fold (95% confidence interval [CI], 1.1-8.2) and subsequent gametocyte carriage 21-fold (95% CI, 14-30). Gastrointestinal complaints in the first 48 h after initiation of treatment were more common among artesunate recipients, but after day 2, dizziness, sleep disturbance, nausea, vomiting, and anorexia were more common among mefloquine recipients (P< or =.014). Artesunate-atovaquone-proguanil is a highly effective and well-tolerated treatment for multidrug-resistant falciparum malaria. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/12471569/Treatment_of_uncomplicated_multidrug_resistant_falciparum_malaria_with_artesunate_atovaquone_proguanil_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/344901 DB - PRIME DP - Unbound Medicine ER -