PMID- 17109092
OWN - NLM
STAT- MEDLINE
DCOM- 20070213
LR  - 20180509
IS  - 1341-321X (Print)
IS  - 1341-321X (Linking)
VI  - 12
IP  - 5
DP  - 2006 Oct
TI  - Efficacy and safety of atovaquone-proguanil compared with mefloquine in the 
      treatment of nonimmune patients with uncomplicated P. falciparum malaria in 
      Japan.
PG  - 277-82
AB  - Malaria treatment is becoming increasingly difficult due to the widespread drug 
      resistance of Plasmodium falciparum. In Japan, only three antimalarials are 
      approved for treatment: oral quinine, sulfadoxine-pyrimethamine, and mefloquine. 
      Recently, however, the Research Group on Chemotherapy of Tropical Diseases 
      introduced atovaquone-proguanil for treating drug-resistant P. falciparum 
      malaria. This research group had also introduced mefloquine before it was 
      licensed nationally. Using data obtained from the research group, we analyzed the 
      efficacy and safety of atovaquone-proguanil, as compared with mefloquine, in 
      nonimmune patients with uncomplicated P. falciparum malaria. Cures were attained 
      in all (100%) of 20 atovaquone-proguanil-treated and 49 (98%) of 50 
      mefloquine-treated adults. The mean fever clearance time (FCT) and parasite 
      clearance time (PCT) appeared to be longer in the atovaquone-proguanil group than 
      in the mefloquine group, but the differences were not statistically significant. 
      Three (15%) of the 20 atovaquone-proguanil-treated adults had adverse events 
      (AEs), all of which were transient elevations of liver enzymes, while 19 (38%) of 
      the 50 mefloquine-treated adults had AEs, including dizziness in 8 (16%) and 
      nausea/vomiting in 7 (14%). All 3 children treated with atovaquone-proguanil were 
      cured without developing AEs. Despite the limitations of this study in not being 
      a formal clinical trial, atovaquone-proguanil seemed to be at least equal to, or 
      even better than, mefloquine for the treatment of uncomplicated P. falciparum 
      malaria in nonimmune patients, including children. Its marketing in Japan could 
      be beneficial in offering an alternative therapeutic option. However, vigilance 
      should be maintained on the possible occurrence of rare but severe AEs, and also 
      of the possible spread of drug resistance.
FAU - Hitani, Akihiro
AU  - Hitani A
AD  - Healthcheck, Health Care Center, Medical Institute Zenjinkai, Yokohama, Japan.
FAU - Nakamura, Tetsuya
AU  - Nakamura T
FAU - Ohtomo, Hiroshi
AU  - Ohtomo H
FAU - Nawa, Yukifumi
AU  - Nawa Y
FAU - Kimura, Mikio
AU  - Kimura M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20061106
PL  - Netherlands
TA  - J Infect Chemother
JT  - Journal of infection and chemotherapy : official journal of the Japan Society of 
      Chemotherapy
JID - 9608375
RN  - 0 (Antimalarials)
RN  - S61K3P7B2V (Proguanil)
RN  - TML814419R (Mefloquine)
RN  - Y883P1Z2LT (Atovaquone)
SB  - IM
MH  - Adult
MH  - Antimalarials/adverse effects/*therapeutic use
MH  - Atovaquone/adverse effects/*therapeutic use
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Immunocompetence
MH  - Infant
MH  - Japan
MH  - Malaria, Falciparum/*drug therapy/immunology
MH  - Male
MH  - Mefloquine/adverse effects/*therapeutic use
MH  - Proguanil/adverse effects/*therapeutic use
EDAT- 2006/11/17 09:00
MHDA- 2007/02/14 09:00
CRDT- 2006/11/17 09:00
PHST- 2006/03/01 00:00 [received]
PHST- 2006/07/13 00:00 [accepted]
PHST- 2006/11/17 09:00 [pubmed]
PHST- 2007/02/14 09:00 [medline]
PHST- 2006/11/17 09:00 [entrez]
AID - S1341-321X(06)70912-6 [pii]
AID - 10.1007/s10156-006-0465-8 [doi]
PST - ppublish
SO  - J Infect Chemother. 2006 Oct;12(5):277-82. doi: 10.1007/s10156-006-0465-8. Epub 
      2006 Nov 6.