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Published on: October 11, 2019
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
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.
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.
- 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.
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