Malaria chemoprophylaxis regimens: a descriptive drug utilization study.

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: Marlene Bloechliger, Patricia Schlagenhauf, Stephen Toovey, Gabriel Schnetzler, Iain Tatt, Danitza Tomianovic, Susan S Jick, Christoph R Meier
• Journal: Travel medicine and infectious disease (Travel Med Infect Dis) 2014 Nov-Dec Vol. 12 Issue 6 Pt B Pg. 718-25 ISSN: 1873-0442 [Electronic] Netherlands
• PMID: 24934849 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Chemical References

• Antimalarials
• Drug Combinations
• atovaquone, proguanil drug combination
• Chloroquine
• Doxycycline
• Proguanil
• Mefloquine
• Atovaquone

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antimalarials (therapeutic use)
• Atovaquone
• Child
• Child, Preschool
• Chloroquine (therapeutic use)
• Doxycycline (therapeutic use)
• Drug Combinations
• Drug Therapy, Combination
• Drug Utilization (statistics & numerical data)
• Female
• Humans
• Infant
• Liver Diseases (epidemiology)
• Malaria (prevention & control)
• Malaria, Falciparum (prevention & control)
• Male
• Mefloquine (therapeutic use)
• Middle Aged
• Pre-Exposure Prophylaxis
• Pregnancy
• Pregnant Women
• Proguanil (therapeutic use)
• Retrospective Studies
• Travel
• Young Adult