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Related Experiment Videos

Atovaquone-proguanil for treating uncomplicated malaria.

A Osei-Akoto1, L Orton, S P O Owusu-Ofori

  • 1Komfo Anokye Teaching Hospital, Department of Child Health, Kumasi, GHANA. oseiyakoto@hotmail.com

The Cochrane Database of Systematic Reviews
|October 20, 2005
PubMed
Summary

Drug resistance is a growing problem for malaria treatment. Atovaquone-proguanil shows promise, with fewer treatment failures than older drugs like chloroquine, amodiaquine, and mefloquine in treating uncomplicated Plasmodium falciparum malaria.

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Area of Science:

  • Malariology
  • Infectious Diseases
  • Pharmacology

Background:

  • Conventional malaria treatments are becoming less effective due to increasing drug resistance in Plasmodium falciparum parasites.
  • Combination therapies, such as atovaquone-proguanil, are being explored as a strategy to overcome drug resistance.

Purpose of the Study:

  • To evaluate the efficacy of atovaquone-proguanil compared to other antimalarial drugs for uncomplicated Plasmodium falciparum malaria in children and adults.
  • To assess treatment failure rates and adverse events associated with atovaquone-proguanil and alternative antimalarial treatments.

Main Methods:

  • A systematic review of randomized controlled trials was conducted, searching multiple databases up to June 2005.
  • Ten trials involving 2345 participants compared atovaquone-proguanil with eight other antimalarial drugs.

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  • Data on treatment eligibility, methodological quality, and outcomes were independently assessed, with intention-to-treat analysis where possible.

    • Main Results:

    • Atovaquone-proguanil demonstrated significantly lower treatment failure rates by day 28 compared to chloroquine, amodiaquine, and mefloquine.
    • Insufficient data precluded definitive conclusions when comparing atovaquone-proguanil with sulfadoxine-pyrimethamine, halofantrine, and newer combination therapies.
    • Adverse events were generally mild and comparable across treatment groups, primarily reflecting common malaria symptoms.

    Conclusions:

    • Atovaquone-proguanil appears more effective than chloroquine, amodiaquine, and mefloquine for treating uncomplicated Plasmodium falciparum malaria.
    • Further research, including large-scale trials, is necessary to compare atovaquone-proguanil with emerging combination therapies and to fully assess its safety profile.
    • Limited data exist for comparisons against several other antimalarial drugs, highlighting the need for more comprehensive studies.