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Atovaquone and proguanil hydrochloride for prophylaxis of malaria.
J Travel Med. 1999 May; 6 Suppl 1:S21-7.JT

Abstract

BACKGROUND

The spread of drug-resistant malaria and appreciation of side effects associated with existing antimalarial drugs emphasize the need for new drugs to prevent malaria. The combination of atovaquone and proguanil hydrochloride was previously shown to be safe and highly effective for treatment of malaria, including multi-drug-resistant Plasmodium falciparum.

METHODS

We reviewed results of clinical trials that evaluated either a fixed-dose combination of atovaquone and proguanil hydrochloride for malaria prophylaxis or atovaquone alone for causal prophylactic activity against P. falciparum.

RESULTS

In three placebo-controlled trials, 331 subjects received 250 mg atovaquone and 100 mg proguanil hydrochloride (or an equivalent dose based on body weight in children) once daily for 10 to 12 weeks. The overall efficacy for preventing parasitemia was 98%. Among 175 nonimmune volunteers taking the same dose of atovaquone/proguanil once daily for 10 weeks while temporarily residing in a malaria-endemic area, malaria developed in one patient who was noncompliant with therapy. Results of volunteer challenge studies indicate that both atovaquone and proguanil have causal prophylactic activity directed against the liver stages of P. falciparum. Adverse events occurred with similar or lower frequencies in subjects treated with atovaquone/proguanil compared to placebo. Less than 1% of patients discontinued from these studies due to a treatment-related adverse event.

CONCLUSION

A fixed-dose combination of atovaquone and proguanil hydrocloride is a promising new alternative for malaria prophylaxis.

Authors+Show Affiliations

US Army Medical Research Unit-Kenya, Nairobi, Kenya.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23573549

Citation

Shanks, G D., et al. "Atovaquone and Proguanil Hydrochloride for Prophylaxis of Malaria." Journal of Travel Medicine, vol. 6 Suppl 1, 1999, pp. S21-7.
Shanks GD, Kremsner PG, Sukwa TY, et al. Atovaquone and proguanil hydrochloride for prophylaxis of malaria. J Travel Med. 1999;6 Suppl 1:S21-7.
Shanks, G. D., Kremsner, P. G., Sukwa, T. Y., van der Berg, J. D., Shapiro, T. A., Scott, T. R., & Chulay, J. D. (1999). Atovaquone and proguanil hydrochloride for prophylaxis of malaria. Journal of Travel Medicine, 6 Suppl 1, S21-7.
Shanks GD, et al. Atovaquone and Proguanil Hydrochloride for Prophylaxis of Malaria. J Travel Med. 1999;6 Suppl 1:S21-7. PubMed PMID: 23573549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atovaquone and proguanil hydrochloride for prophylaxis of malaria. AU - Shanks,G D, AU - Kremsner,P G, AU - Sukwa,T Y, AU - van der Berg,J D, AU - Shapiro,T A, AU - Scott,T R, AU - Chulay,J D, AU - ,, PY - 2013/4/11/entrez PY - 1999/5/1/pubmed PY - 2013/6/29/medline SP - S21 EP - 7 JF - Journal of travel medicine JO - J Travel Med VL - 6 Suppl 1 N2 - BACKGROUND: The spread of drug-resistant malaria and appreciation of side effects associated with existing antimalarial drugs emphasize the need for new drugs to prevent malaria. The combination of atovaquone and proguanil hydrochloride was previously shown to be safe and highly effective for treatment of malaria, including multi-drug-resistant Plasmodium falciparum. METHODS: We reviewed results of clinical trials that evaluated either a fixed-dose combination of atovaquone and proguanil hydrochloride for malaria prophylaxis or atovaquone alone for causal prophylactic activity against P. falciparum. RESULTS: In three placebo-controlled trials, 331 subjects received 250 mg atovaquone and 100 mg proguanil hydrochloride (or an equivalent dose based on body weight in children) once daily for 10 to 12 weeks. The overall efficacy for preventing parasitemia was 98%. Among 175 nonimmune volunteers taking the same dose of atovaquone/proguanil once daily for 10 weeks while temporarily residing in a malaria-endemic area, malaria developed in one patient who was noncompliant with therapy. Results of volunteer challenge studies indicate that both atovaquone and proguanil have causal prophylactic activity directed against the liver stages of P. falciparum. Adverse events occurred with similar or lower frequencies in subjects treated with atovaquone/proguanil compared to placebo. Less than 1% of patients discontinued from these studies due to a treatment-related adverse event. CONCLUSION: A fixed-dose combination of atovaquone and proguanil hydrocloride is a promising new alternative for malaria prophylaxis. SN - 1195-1982 UR - https://www.unboundmedicine.com/medline/citation/23573549/Atovaquone_and_proguanil_hydrochloride_for_prophylaxis_of_malaria_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1195-1982&date=1999&volume=6&issue=&spage=S21 DB - PRIME DP - Unbound Medicine ER -