title: Early treatment failure during treatment of Plasmodium falciparum malaria with atovaquone-proguanil in the Republic of Ivory Coast.
abstract: The increased spread of drug-resistant malaria highlights the need for alternative drugs for treatment and chemoprophylaxis. The combination of atovaquone-proguanil (Malarone®) has shown high efficacy against Plasmodium falciparum with only mild side-effects. Treatment failures have been attributed to suboptimal dosages or to parasite resistance resulting from a point mutation in the cytochrome b gene. In this paper, a case of early treatment failure was reported in a patient treated with atovaquone-proguanil; this failure was not associated with a mutation in the parasite cytochrome b gene, with impaired drug bioavailability, or with re-infection.
authors.affiliation: Unité de Parasitologie - Unité de Recherche pour les Maladies Infectieuses et Tropicales Emergentes - UMR 6236, Institut de Recherche Biomédicale des Armées, Marseille, France. nathalie_wurtz@yahoo.fr
authors.forename: Nathalie
authors.initials: N
authors.lastname: Wurtz
authors.forename: Aurélie
authors.initials: A
authors.lastname: Pascual
authors.forename: Adeline
authors.initials: A
authors.lastname: Marin-Jauffre
authors.forename: Housem
authors.initials: H
authors.lastname: Bouchiba
authors.forename: Nicolas
authors.initials: N
authors.lastname: Benoit
authors.forename: Marc
authors.initials: M
authors.lastname: Desbordes
authors.forename: Maryse
authors.initials: M
authors.lastname: Martelloni
authors.forename: Vincent
authors.initials: V
authors.lastname: Pommier de Santi
authors.forename: Georges
authors.initials: G
authors.lastname: Richa
authors.forename: Nicolas
authors.initials: N
authors.lastname: Taudon
authors.forename: Bruno
authors.initials: B
authors.lastname: Pradines
authors.forename: Sébastien
authors.initials: S
authors.lastname: Briolant
mesh_terms: D000962:Antimalarials / Q000008:administration & dosage*; D053626:Atovaquone / Q000008:administration & dosage*; D007560:Cote d'Ivoire; D045303:Cytochromes b / Q000235:genetics; D004338:Drug Combinations; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000187:drug effects / Q000235:genetics; D002727:Proguanil / Q000008:administration & dosage*; D017211:Treatment Failure
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C109496:atovaquone, proguanil drug combination; D045303:Cytochromes b; D002727:Proguanil; D053626:Atovaquone