[Atovaquone/proguanil. Prophylaxis and treatment of malaria]

Malarone is a combination of the two drugs atovaquone and proguanil. Malarone is useful as prophylaxis and for the treatment of falciparum malaria. Monotherapy using atovaquone or proguanil results in treatment failure in 30% and 90% respectively, whereas treatment failure is rare when a combination of the drugs is used (< 2%). This reflects the synergistic effect of this drug combination. Used as a chemoprophylaticum against falciparum malaria Malarone has an effect of > 95%. The protective mechanism is likely to act via the mitochondrial cytochrome bc complex, thus a different mechanism from other malaria drugs. For this reason, cross-resistance with other malaria drugs is not expected. The documentation of effect and safety profile of Malarone in malaria prophylaxis makes it a suitable alternative to mefloquine and doxycycline in case of contraindications. Malarone is effective for the treatment of acute uncomplicated malaria, and may be used as an alternative to mefloquine.