Journal Article

Malaria Prophylaxis Using Azithromycin: A Double-Blind, Placebo-Controlled Trial in Irian Jaya, Indonesia

Walter R. J. Taylor, Thomas L. Richie, David J. Fryauff, Helena Picarima, Colin Ohrt, Douglas Tang, David Braitman, Gerald S. Murphy, Hendra Widjaja, Emiliana Tjitra, Asep Ganjar, Trevor R. Jones, Hasan Basri and Josh Berman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 1, pages 74-81
Published in print January 1999 | ISSN: 1058-4838
Published online January 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515071
Malaria Prophylaxis Using Azithromycin: A Double-Blind, Placebo-Controlled Trial in Irian Jaya, Indonesia

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New drugs are needed for preventing drug-resistant Plasmodium falciparum malaria. The prophylactic efficacy of azithromycin against P. falciparum in malaria-immune Kenyans was 83%. We conducted a double-blind, placebo-controlled trial to determine the prophylactic efficacy of azithromycin against multidrug-resistant P. falciparum malaria and chloroquine-resistant Plasmodium vivax malaria in Indonesian adults with limited immunity. After radical cure therapy, 300 randomized subjects received azithromycin (148 subjects, 750-mg loading dose followed by 250 mg/d), placebo (77), or doxycycline (75, 100 mg/d). The end point was slide-proven parasitemia. There were 58 P. falciparum and 29 P. vivax prophylaxis failures over 20 weeks. Using incidence rates, the protective efficacy of azithromycin relative to placebo was 71.6% (95% confidence interval [CI], 50.3–83.8) against P. falciparum malaria and 98.9% (95% CI, 93.1–99.9) against P. vivax malaria. Corresponding figures for doxycycline were 96.3% (95% CI, 85.4–99.6) and 98% (95% CI, 88.0–99.9), respectively. Daily azithromycin offered excellent protection against P. vivax malaria but modest protection against P. falciparum malaria.

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

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