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1
Trape JF, Pison G, Spiegel A, Enel C, 2002. Combating malaria in Africa. Trends Parasitol 18 :224–230.
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van Vugt M, Leonardi E, Phaipun L, Slight T, Thway K, McGready R, Brockman A, Villegas L, Looareesuwan S, White NJ, Nosten F, 2002. Treatment of uncomplicated multidrug resistant falciparum malaria with artesunate-atovaquone-proguanil. Clin Infect Dis 15 :1498–1504.
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Karbwang J, Davis T, Looareesuwan S, Molunto P, Bunnag D, White NJ, 1993. A comparison of the pharmacokinetic and pharmacodynamic properties of qunine and quinidine in healthy Thai males. Br J Pharmacol 35 :265–271.
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Nosten F, ter Kuile F, Luxemburger C, Woodrow C, Kyle D, Chongsuphajaisiddhi T, White NJ, 1993. Cardiac effects of antimalarial treatment with halofantrine. Lancet 341 :1054–1056.
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van Vugt M, Ezzet F, Nosten F, Gathmann I, Wilairatna P, Looareesuwan S, White NJ, 1999. No evidence of cardiotoxicity during antimalarial treatment with artemether-lumefantrine. Am J Trop Med Hyg 61 :964–967.
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ter Kuile F, Nosten F, Luxemburger C, Kyle D, Teja-Isavatharm P, Phaipun L, Price R, Chongsuphajaisiddhi T, White NJ, 1995. Mefloquine treatment of acute falciparum malaria: a prospective study of non-serious adverse effects in 3673 patients. Bull World Health Organ 73 :631–642.
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NO EVIDENCE OF CARDIOTOXICITY OF ATOVAQUONE-PROGUANIL ALONE OR IN COMBINATION WITH ARTESUNATE
Combinations are set to become the mainstay in treatment and prophylaxis of malaria due to Plasmodium falciparum. Various antimalarials have been implicated in cardiotoxicity via prolongation of the QTc interval. Atovaquone-proguanil is an effective and increasingly popular antimalarial choice when used alone or with artesunate in areas of drug resistance. We report the results of an investigation carried out on the Thai-Burmese border in 42 patients randomized to receive either atovaquone-proguanil or atovaquone-proguanil-artesunate for three days. Electrocardiographic recordings were made at baseline and one hour after each dose. There was no statistically significant change in QTc interval between baseline and any subsequent readings in either treatment group or the cohort as a whole. We conclude that atovaquone-proguanil shows no evidence of cardiotoxicity either alone or when combined with artesunate.