Malaria chemoprophylaxis in the age of drug resistance. I. Currently recommended drug regimens.
As international travel becomes increasingly common and resistance to antimalarial drugs escalates, a growing number of travelers are at risk for contracting malaria. Parasite resistance to chloroquine and proguanil and real or perceived intolerance among patients to standard prophylactic agents such as mefloquine have highlighted the need for new antimalarial drugs. Promising new regimens include atovaquone and proguanil, in combination; primaquine; and a related 8-aminoquinoline, tafenoquine. These agents are active against the liver stage of the malaria parasite and therefore can be discontinued shortly after the traveler leaves an area where malaria is endemic, which encourages adherence to the treatment regimen. Part 1 of this series reviews currently recommended chemoprophylactic drug regimens, and part 2 will focus on 8-aminoquinoline drugs.
Kain
K C
KC
Centre for Travel and Tropical Medicine, Division of Infectious Diseases, Department of Medicine, Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada. kevin.kain@uhn.on.ca
Shanks
G D
GD
Keystone
J S
JS
D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D053626:Atovaquone; D017963:Azithromycin / Q000627:therapeutic use; D002738:Chloroquine / Q000627:therapeutic use; D004351:Drug Resistance; D006287:Health Planning Guidelines; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology; D015767:Mefloquine / Q000627:therapeutic use; D009285:Naphthoquinones / Q000627:therapeutic use; D010963:Plasmodium falciparum / Q000187:drug effects; D011319:Primaquine / Q000627:therapeutic use; D002727:Proguanil / Q000627:therapeutic use
D000962:Antimalarials; D009285:Naphthoquinones; D017963:Azithromycin; D002738:Chloroquine; D011319:Primaquine; D002727:Proguanil; D015767:Mefloquine; D053626:Atovaquone