Journal Article

Atovaquone-Proguanil versus Mefloquine for Malaria Prophylaxis in Nonimmune Travelers: Results from a Randomized, Double-Blind Study

David Overbosch, Herbert Schilthuis, Ulrich Bienzle, Ronald H. Behrens, Kevin C. Kain, Paul D. Clarke, Stephen Toovey, Jürgen Knobloch, Hans Dieter Nothdurft, Dea Shaw, Neil S. Roskell and Jeffrey D. Chulay

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 7, pages 1015-1021
Published in print October 2001 | ISSN: 1058-4838
Published online October 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/322694
Atovaquone-Proguanil versus Mefloquine for Malaria Prophylaxis in Nonimmune Travelers: Results from a Randomized, Double-Blind Study

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Concerns about the tolerability of mefloquine highlight the need for new drugs to prevent malaria. Atovaquone-proguanil (Malarone; GlaxoSmithKline) was safe and effective for prevention of falciparum malaria in lifelong residents of malaria-endemic countries, but experience in nonimmune people is limited. In a randomized, double-blind study, nonimmune travelers received malaria prophylaxis with atovaquone-proguanil (493 subjects) or mefloquine (483 subjects). Information about adverse events (AEs) and potential episodes of malaria was obtained 7, 28, and 60 days after travel. AEs were reported by an equivalent proportion of subjects who had received atovaquone-proguanil or mefloquine (71.4% versus 67.3%; difference, 4.1%; 95% confidence interval, -1.71 to 9.9). Subjects who received atovaquone-proguanil had fewer treatment-related neuropsychiatric AEs (14% versus 29%; P = .001), fewer AEs of moderate or severe intensity (10% versus 19%; P = .001), and fewer AEs that caused prophylaxis to be discontinued (1.2% versus 5.0%; P = .001), compared with subjects who received melfoquine. No confirmed diagnoses of malaria occurred in either group. Atovaquone-proguanil was better tolerated than was mefloquine, and it was similarly effective for malaria prophylaxis in nonimmune travelers.

Journal Article.  3986 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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