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Atovaquone plus proguanil versus halofantrine for the treatment of imported acute uncomplicated Plasmodium falciparum malaria in non-immune adults: a randomized comparative trial.

Abstract
In endemic zones, the atovaquone-proguanil (AP) combination is well tolerated and effective in treating acute, uncomplicated malaria. Trials involving non-immune patients are lacking, however. We conducted a randomized, multicenter open-label trial to determine the efficacy and tolerability of the AP combination (1,000 mg + 400 mg once daily for 3 days) in comparison with halofantrine (HF) (1,500 mg in 3 doses) in non-immune adults with imported uncomplicated Plasmodium falciparum malaria. Follow-up visits were programmed on Days 7, 14, 21, 28, and 35 after hospital discharge. Out of 48 patients enrolled in the study, 41 were assessable for the cure rate (21 in the AP group and 20 in the HF group). All the patients were cured. The mean parasite clearance time was longer (63+/-23 hours) in the AP group than in the HF group (48+/-15 hours) (P = 0.02). The frequency of gastrointestinal adverse events was higher in the AP group. No noteworthy electrocardiographic changes were observed, particularly in the QTc interval. The AP combination appears to be a valuable alternative treatment in non-immune adults.
AuthorsO Bouchaud, E Monlun, K Muanza, A Fontanet, T Scott, A Goetschel, J D Chulay, J Le Bras, M Danis, M Le Bras, J P Coulaud, M Gentilini
JournalThe American journal of tropical medicine and hygiene (Am J Trop Med Hyg) 2000 Nov-Dec Vol. 63 Issue 5-6 Pg. 274-9 ISSN: 0002-9637 [Print] United States
PMID11421377 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antimalarials
  • Naphthoquinones
  • Phenanthrenes
  • halofantrine
  • Proguanil
  • Atovaquone
Topics
  • Acute Disease
  • Administration, Oral
  • Adolescent
  • Adult
  • Antimalarials (administration & dosage)
  • Atovaquone
  • Drug Therapy, Combination
  • Female
  • France
  • Humans
  • Malaria, Falciparum (drug therapy)
  • Male
  • Middle Aged
  • Naphthoquinones (administration & dosage)
  • Phenanthrenes (administration & dosage)
  • Proguanil (administration & dosage)
  • Treatment Outcome

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