[Tolerance and efficacy of atovaquone-proguanil for the treatment of paediatric imported Plasmodium falciparum malaria in France: clinical practice in a university hospital in Paris].

Abstract

UNLABELLED:

Only few drugs for uncomplicated Plasmodium falciparum malaria are available in children. Atovaquone-proguanil is a recent antimalarial drug licensed in France for the uncomplicated P. falciparum malaria in adults. Few paediatric studies have evaluated atovaquone-proguanil in children for uncomplicated malaria in endemic area, but no study have evaluated this treatment for imported malaria.

OBJECTIVE:

To evaluate treatment by atovaquone-proguanil for uncomplicated and imported P. falciparum malaria in children.

METHODS:

We retrospectively evaluated the tolerance and the efficacy of atovaquone-proguanil in the children admitted in Robert-Debré Hospital (Paris) for a P. falciparum malaria. From January 2004 to December 2005, 48 children with a median age of 7,5 years (IQR 4-11) were treated with atovaquone-proguanil for a uncomplicated P. falciparum malaria, except for 5 children who had an isolated hyperparasitemia greater or equal to 5%.

RESULTS:

Atovaquone-proguanil was stopped for 3/48 children because of vomiting. Fever resolved in all the children between Day 3 and 7, following the beginning of the treatment. One child, with a favourable outcome, had a positive parasitemia at Day 4 equal to the initial parasitemia (0,1%). No late therapeutic failure was observed among the 24 children evaluated up to one month after starting treatment.

CONCLUSION:

Atovaquone-proguanil is an efficient and well-tolerated antimalarial treatment for uncomplicated P. falciparum malaria in children. The risk of vomiting should lead to a systematic initial hospitalisation of children treated with atovaquone-proguanil.

• Authors: R Blondé, J Naudin, Z Bigirimana, L Holvoet, O Fenneteau, C Vitoux, O Bourdon, F Angoulvant, M Lorrot, E D'Ortenzio, A Bourrillon, J Le Bras, S Matheron, A Faye
• Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie (Arch Pediatr) Vol. 15 Issue 3 Pg. 245-52 (Mar 2008) ISSN: 0929-693X [Print] France
• Vernacular Title: Tolérance et efficacité de l'atovaquone-proguanil dans le traitement du paludisme d'importation àPlasmodium falciparum de l'enfant en France métropolitaine: expérience d'un centre hospitalier parisien.
• PMID: 18321692 (Publication Type: English Abstract, Journal Article)

Chemical References

• Antimalarials
• Drug Combinations
• atovaquone, proguanil drug combination
• C-Reactive Protein
• Proguanil
• Atovaquone

Topics

• Animals
• Antimalarials (therapeutic use)
• Atovaquone (therapeutic use)
• C-Reactive Protein (metabolism)
• Child
• Child, Preschool
• Drug Combinations
• Drug Therapy, Combination
• Drug Tolerance
• Hospitals, University
• Humans
• Liver Function Tests
• Malaria, Falciparum (drug therapy)
• Paris
• Plasmodium falciparum
• Proguanil (therapeutic use)
• Retrospective Studies
• Travel