Efficacy of atovaquone-proguanil for treatment of acute multidrug-resistant Plasmodium falciparum malaria in Thailand.

Abstract

A combination of atovaquone-proguanil (Malarone); GlaxoSmithKline, Research Triangle Park, NC) was previously shown to be highly effective in the treatment of uncomplicated Plasmodium falciparum malaria. However, there are only limited recent efficacy data, particularly from regions of multidrug resistance. In this study, we examined the efficacy of atovaquone-proguanil for the treatment of uncomplicated P. falciparum malaria on the Thailand-Myanmar border. Patients were given directly observed atovaquone-proguanil (1,000 mg/400 mg) once a day for three days and followed-up for four weeks in a non-transmission area. Of 140 eligible patients enrolled in this open-label study, 97.8% (95% confidence interval = 95.4-100%) responded to therapy and remained clear of parasitemia at follow-up. Mean parasite clearance time was 41.9 hours and mean fever clearance time was 37.1 hours. On the basis of genotyping, three cases of treatment failure were identified (1 RIII and 2 RI). These data indicate that atovaquone-proguanil remains highly efficacious for the treatment of multidrug-resistant P. falciparum malaria in Thailand.

• Authors: Srivicha Krudsood, Samir N Patel, Nopaddon Tangpukdee, Wipa Thanachartwet, Wattana Leowattana, Karnchana Pornpininworakij, Andrea K Boggild, Sornchai Looareesuwan, Kevin C Kain
• Journal: The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 76 Issue 4 Pg. 655-8 (Apr 2007) ISSN: 0002-9637 [Print] United States
• PMID: 17426165 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antimalarials
• Proguanil
• Atovaquone

Topics

• Adolescent
• Adult
• Animals
• Antimalarials (administration & dosage, therapeutic use)
• Atovaquone (administration & dosage, therapeutic use)
• Drug Resistance, Multiple
• Drug Therapy, Combination
• Female
• Humans
• Malaria, Falciparum (drug therapy, epidemiology, parasitology)
• Male
• Middle Aged
• Plasmodium falciparum (drug effects)
• Proguanil (administration & dosage, therapeutic use)
• Thailand (epidemiology)