Atovaquone and proguanil versus amodiaquine for the treatment of Plasmodium falciparum malaria in African infants and young children.
Malaria-related morbidity and mortality are greatest among young children in areas with high malaria transmission intensity. An open-label, randomized study was done to evaluate the efficacy and safety of the combination of atovaquone and proguanil formulated as pediatric-strength tablets (20 and 8 mg/kg of body weight, respectively, administered once daily for 3 days), compared with amodiaquine (10 mg/kg of body weight, once daily for 3 days), among children weighing > or =5 and <11 kg in Gabon. Two hundred patients aged 3-43 months were recruited. Use of atovaquone/proguanil resulted in a cure rate on day 28 of 95% (87 of 92 children), compared with 53% (41 of 78 children) for amodiaquine (difference, 42%; 95% CI, 30%-54%; P<.001). The incidence of adverse events was similar in both groups, and no serious adverse events were attributed to the use of atovaquone/proguanil. Atovaquone/proguanil was found to be highly effective and safe for the treatment of Plasmodium falciparum malaria in infants and young children weighing 5-10 kg in Africa.
Borrmann
Steffen
S
Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon. steffen.borrmann@uni-tuebingen.de
Faucher
Jean-François
JF
Bagaphou
Thierry
T
Missinou
Michel A
MA
Binder
Ronald K
RK
Pabisch
Sophia
S
Rezbach
Philipp
P
Matsiegui
Pierre-Blaise
PB
Lell
Bertrand
B
Miller
Gerri
G
Kremsner
Peter G
PG
D000655:Amodiaquine / Q000627:therapeutic use*; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D053626:Atovaquone; D002648:Child; D004338:Drug Combinations; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D009285:Naphthoquinones / Q000627:therapeutic use*; D002727:Proguanil / Q000627:therapeutic use*; D016896:Treatment Outcome
D000962:Antimalarials; D004338:Drug Combinations; D009285:Naphthoquinones; D000655:Amodiaquine; D002727:Proguanil; D053626:Atovaquone