title: Atovaquone and proguanil versus amodiaquine for the treatment of Plasmodium falciparum malaria in African infants and young children.
abstract: 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.
authors: Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon. steffen.borrmann@uni-tuebingen.de
authors: Steffen
authors: S
authors: Borrmann
authors: Jean-François
authors: JF
authors: Faucher
authors: Thierry
authors: T
authors: Bagaphou
authors: Michel A
authors: MA
authors: Missinou
authors: Ronald K
authors: RK
authors: Binder
authors: Sophia
authors: S
authors: Pabisch
authors: Philipp
authors: P
authors: Rezbach
authors: Pierre-Blaise
authors: PB
authors: Matsiegui
authors: Bertrand
authors: B
authors: Lell
authors: Gerri
authors: G
authors: Miller
authors: Peter G
authors: PG
authors: Kremsner
mesh_terms: 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
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D009285:Naphthoquinones; D000655:Amodiaquine; D002727:Proguanil; D053626:Atovaquone