Atovaquone and proguanil hydrochloride for prophylaxis of malaria

G. Dennis Shanks, Peter G. Kremsner, Thomas Y. Sukwa, J. Dirk Van Der Berg, Theresa A Shapiro, Trevor R. Scott, Jeffrey D. Chulay

Research output: Contribution to journalArticle

Abstract

Background: The spread of drug-resistant malaria and appreciation of side effects associated with existing antimalarial drugs emphasize the need for new drugs to prevent malaria. The combination of atovaquone and proguanil hydrochloride was previously shown to be safe and highly effective for treatment of malaria, including multi-drug-resistant Plasmodium falciparum. Methods: We reviewed results of clinical trials that evaluated either a fixed-dose combination of atovaquone and proguanil hydrochloride for malaria prophylaxis or atovaquone alone for causal prophylactic activity against P. falciparum. Results: In three placebo-controlled trials, 331 subjects received 250 mg atovaquone and 100 mg proguanil hydrochloride (or an equivalent dose based on body weight in children) once daily for 10 to 12 weeks. The overall efficacy for preventing parasitemia was 98%. Among 175 nonimmune volunteers taking the same dose of atovaquone/proguanil once daily for 10 weeks while temporarily residing in a malaria-endemic area, malaria developed in one patient who was noncompliant with therapy. Results of volunteer challenge studies indicate that both atovaquone and proguanil have causal prophylactic activity directed against the liver stages of P. falciparum. Adverse events occurred with similar or lower frequencies in subjects treated with atovaquone/proguanil compared to placebo. Less than 1% of patients discontinued from these studies due to a treatment-related adverse event. Conclusion: A fixed-dose combination of atovaquone and proguanil hydrochloride is a promising new alternative for malaria prophylaxis.

Original languageEnglish (US)
JournalJournal of Travel Medicine
Volume6
Issue numberSUPPL. 1
StatePublished - May 1999

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Proguanil
Malaria
Plasmodium falciparum
Atovaquone
Volunteers
Placebos
Pharmaceutical Preparations
Parasitemia
Antimalarials
proguanil drug combination atovaquone
Therapeutics
Body Weight
Clinical Trials
Liver

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Shanks, G. D., Kremsner, P. G., Sukwa, T. Y., Van Der Berg, J. D., Shapiro, T. A., Scott, T. R., & Chulay, J. D. (1999). Atovaquone and proguanil hydrochloride for prophylaxis of malaria. Journal of Travel Medicine, 6(SUPPL. 1).

Atovaquone and proguanil hydrochloride for prophylaxis of malaria. / Shanks, G. Dennis; Kremsner, Peter G.; Sukwa, Thomas Y.; Van Der Berg, J. Dirk; Shapiro, Theresa A; Scott, Trevor R.; Chulay, Jeffrey D.

In: Journal of Travel Medicine, Vol. 6, No. SUPPL. 1, 05.1999.

Research output: Contribution to journalArticle

Shanks, GD, Kremsner, PG, Sukwa, TY, Van Der Berg, JD, Shapiro, TA, Scott, TR & Chulay, JD 1999, 'Atovaquone and proguanil hydrochloride for prophylaxis of malaria', Journal of Travel Medicine, vol. 6, no. SUPPL. 1.
Shanks GD, Kremsner PG, Sukwa TY, Van Der Berg JD, Shapiro TA, Scott TR et al. Atovaquone and proguanil hydrochloride for prophylaxis of malaria. Journal of Travel Medicine. 1999 May;6(SUPPL. 1).
Shanks, G. Dennis ; Kremsner, Peter G. ; Sukwa, Thomas Y. ; Van Der Berg, J. Dirk ; Shapiro, Theresa A ; Scott, Trevor R. ; Chulay, Jeffrey D. / Atovaquone and proguanil hydrochloride for prophylaxis of malaria. In: Journal of Travel Medicine. 1999 ; Vol. 6, No. SUPPL. 1.
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