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Malaria chemoprophylaxis regimens: a descriptive drug utilization study.
Travel Med Infect Dis. 2014 Nov-Dec; 12(6 Pt B):718-25.TM

Abstract

BACKGROUND

Mefloquine belongs to the priority chemoprophylaxis drugs for travelers to malaria endemic regions. We aimed to assess the prescribing patterns for mefloquine and other antimalarials.

METHODS

We conducted a descriptive drug utilization study using the U.K. Clinical Practice Research Datalink (CPRD). We assessed characteristics of individuals with a first-time antimalarial prescription for mefloquine, atovaquone/proguanil, chloroquine and/or proguanil, or doxycycline between 2001 and 2012.

RESULTS

Of 165,218 individuals with a first-time antimalarial prescription, 108,344 (65.6%), 25,294 (15.3%), 23,195 (14.0%), and 8385 (5.1%) were prescribed atovaquone/proguanil, mefloquine, doxycycline, and chloroquine and/or proguanil, respectively. Among mefloquine users, 7.5% had a history of a neuropsychiatric disorder (versus 12.6%-13.7% among other antimalarial users) and 0.04% had a history of severe liver disease (versus 0.04%-0.1% among other antimalarial users). A total of 19.4% mefloquine users were children younger than 12 years (versus 0.4%-15.8% among other antimalarials), and 1.3% pregnant or postpartum women (versus 0.4%-1.4% among users of other antimalarials).

CONCLUSIONS

The most frequently prescribed antimalarial chemoprophylaxis was atovaquone/proguanil. Mefloquine was occasionally prescribed for patients with comorbidities listed as contraindications, but most practitioners observed contraindications. Mefloquine was often prescribed for children and pregnant women.

Authors+Show Affiliations

Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy & Epidemiology, Department of Pharmaceutical Sciences, University Basel, Switzerland. Electronic address: Marlene.Bloechliger@usb.ch.University of Zurich Centre for Travel Medicine, Institute for Social and Preventive Medicine, Zurich, Switzerland. Electronic address: pat@ifspm.uzh.ch.Division of Infection and Immunity, Royal Free and University College Medical School, Academic Centre for Travel Medicine and Vaccines, London, UK. Electronic address: malaria@sunrise.ch.F.Hoffmann-La Roche Ltd., Basel, Switzerland. Electronic address: gabriel.schnetzler@roche.com.F.Hoffmann-La Roche Ltd., Basel, Switzerland. Electronic address: iain.tatt@roche.com.F.Hoffmann-La Roche Ltd., Basel, Switzerland. Electronic address: danitza.tomianovic@roche.com.Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, United States. Electronic address: sjick@bu.edu.Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy & Epidemiology, Department of Pharmaceutical Sciences, University Basel, Switzerland; Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, United States; Hospital Pharmacy, University Hospital Basel, Switzerland. Electronic address: Christoph.Meier@usb.ch.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24934849

Citation

Bloechliger, Marlene, et al. "Malaria Chemoprophylaxis Regimens: a Descriptive Drug Utilization Study." Travel Medicine and Infectious Disease, vol. 12, no. 6 Pt B, 2014, pp. 718-25.
Bloechliger M, Schlagenhauf P, Toovey S, et al. Malaria chemoprophylaxis regimens: a descriptive drug utilization study. Travel Med Infect Dis. 2014;12(6 Pt B):718-25.
Bloechliger, M., Schlagenhauf, P., Toovey, S., Schnetzler, G., Tatt, I., Tomianovic, D., Jick, S. S., & Meier, C. R. (2014). Malaria chemoprophylaxis regimens: a descriptive drug utilization study. Travel Medicine and Infectious Disease, 12(6 Pt B), 718-25. https://doi.org/10.1016/j.tmaid.2014.05.006
Bloechliger M, et al. Malaria Chemoprophylaxis Regimens: a Descriptive Drug Utilization Study. Travel Med Infect Dis. 2014 Nov-Dec;12(6 Pt B):718-25. PubMed PMID: 24934849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Malaria chemoprophylaxis regimens: a descriptive drug utilization study. AU - Bloechliger,Marlene, AU - Schlagenhauf,Patricia, AU - Toovey,Stephen, AU - Schnetzler,Gabriel, AU - Tatt,Iain, AU - Tomianovic,Danitza, AU - Jick,Susan S, AU - Meier,Christoph R, Y1 - 2014/06/02/ PY - 2013/12/03/received PY - 2014/05/08/accepted PY - 2014/6/18/entrez PY - 2014/6/18/pubmed PY - 2015/9/9/medline KW - Atovaquone KW - Chloroquine KW - Doxycycline KW - Mefloquine KW - Proguanil SP - 718 EP - 25 JF - Travel medicine and infectious disease JO - Travel Med Infect Dis VL - 12 IS - 6 Pt B N2 - BACKGROUND: Mefloquine belongs to the priority chemoprophylaxis drugs for travelers to malaria endemic regions. We aimed to assess the prescribing patterns for mefloquine and other antimalarials. METHODS: We conducted a descriptive drug utilization study using the U.K. Clinical Practice Research Datalink (CPRD). We assessed characteristics of individuals with a first-time antimalarial prescription for mefloquine, atovaquone/proguanil, chloroquine and/or proguanil, or doxycycline between 2001 and 2012. RESULTS: Of 165,218 individuals with a first-time antimalarial prescription, 108,344 (65.6%), 25,294 (15.3%), 23,195 (14.0%), and 8385 (5.1%) were prescribed atovaquone/proguanil, mefloquine, doxycycline, and chloroquine and/or proguanil, respectively. Among mefloquine users, 7.5% had a history of a neuropsychiatric disorder (versus 12.6%-13.7% among other antimalarial users) and 0.04% had a history of severe liver disease (versus 0.04%-0.1% among other antimalarial users). A total of 19.4% mefloquine users were children younger than 12 years (versus 0.4%-15.8% among other antimalarials), and 1.3% pregnant or postpartum women (versus 0.4%-1.4% among users of other antimalarials). CONCLUSIONS: The most frequently prescribed antimalarial chemoprophylaxis was atovaquone/proguanil. Mefloquine was occasionally prescribed for patients with comorbidities listed as contraindications, but most practitioners observed contraindications. Mefloquine was often prescribed for children and pregnant women. SN - 1873-0442 UR - https://www.unboundmedicine.com/medline/citation/24934849/Malaria_chemoprophylaxis_regimens:_a_descriptive_drug_utilization_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-8939(14)00114-8 DB - PRIME DP - Unbound Medicine ER -