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The fixed dose combination of atovaquone and proguanil hydrochloride, marketed under the trade name MalaroneTM, is the most recently approved agent in North America for the prevention and treatment of chloroquine- and multi-drug resistant Plasmodium falciparum malaria. In both adult and pediatric populations, atovaquone-proguanil demonstrates consistently high protective efficacy against P. falciparum, and in treatment trials, cure rates exceed 93%. Only a handful of genetically confirmed treatment failures have been reported to date. Atovaquone-proguanil has an excellent safety profile during both prophylaxis and treatment courses, with severe adverse events rarely reported. This topical review will examine the evidence behind the current indications for use of atovaquone-proguanil, and will summarize the current body of literature surrounding safety and tolerability.
Received July 20, 2006. Accepted for publication October 2, 2006.
Acknowledgment: Presented at the Centers for Disease Control and Prevention Expert Meeting on Malaria Prevention, January 29–30, 2003, Atlanta, Georgia.
Disclosure: Kevin Kain was on the speakers’ bureau for GlaxoSmith-Kline. This statement is made in the interest of full disclosure and not because the author considers this to be a conflict of interest.
Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
* Address correspondence to Andrea Boggild, Dept. of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. E-mail: andrea.boggild{at}utoronto.ca
Authors’ addresses: Andrea K. Boggild, Dept. of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Dept. of Microbiology, Mt. Sinai Hospital, 600 University Avenue, Room 1485, Toronto, ON M5G 1X5, Canada, Telephone: 416-586-4695, Fax: 416-586-8746, E-mail: andrea.boggild{at}utoronto.ca. Capt. Monica E. Parise, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway MS F22, Atlanta, GA 30341, Telephone: 770-488-7786, Fax: 770-488-7761, E-mail: mparise{at}cdc.gov. Linda S. Lewis, Health Studies Consulting, Medford, OR 97501, Telephone: 541-608-9027, Fax: 541-734-2410, E-mail: lslewis_dvm_mpvm{at}sbcglobal.net. Kevin C. Kain, Center for Travel and Tropical Medicine, Toronto General Hospital, Dept. of Medicine, University of Toronto, McLaughlin-Rotman Centre McLaughlin Center for Molecular Medicine, 200 Elizabeth Street, EN-13-214, Toronto, ON M5G 2C4, Canada, Telephone: 416-340-3535, Fax: 416-595-5826, E-mail: Kevin.Kain{at}uhn.on.ca.
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