Proguanil-sulphonamide for malaria prophylaxis.
There are few safe, effective chemoprophylactic regimens for preventing Plasmodium falciparum infection in south-east Asia. In two randomized placebo-controlled trials, combinations of proguanil and sulphonamide were tested for chemoprophylactic activity in schoolchildren, aged 6-15 years, living near the Thai-Burmese border. Proguanil at an equivalent adult dose of 200 mg/d was combined with sulphafurazole (= sulfisoxazole) at 25 mg/kg/d or sulphamethoxazole at 25 and 10 mg/kg/d. Combinations of daily proguanil/sulphafurazole and proguanil/sulphamethoxazole were equally effective (greater than 75%) against both falciparum and vivax malaria when the sulphonamide component was used at 25 mg/kg/d. Proguanil and sulphamethoxazole at 10 mg/kg/d was ineffective. Approximately 1% of the children had sulphonamide-related skin rashes which resolved when treatment stopped. Proguanil/sulphonamide is a possible alternative chemoprophylactic regimen in areas with multiple drug-resistant P. falciparum.
Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
J J
JJ
Karwacki
G D
GD
Shanks
N
N
Limsomwong
P
P
Singharaj
D000293:Adolescent; D000818:Animals; D002648:Child; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D010963:Plasmodium falciparum; D010966:Plasmodium vivax; D002727:Proguanil / Q000008:administration & dosage / Q000627:therapeutic use*; D013420:Sulfamethoxazole / Q000008:administration & dosage / Q000627:therapeutic use*; D013444:Sulfisoxazole / Q000008:administration & dosage / Q000627:therapeutic use*
D004338:Drug Combinations; D013444:Sulfisoxazole; D013420:Sulfamethoxazole; D002727:Proguanil