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Atovaquone and Proguanil versus Amodiaquine for the Treatment of Plasmodium falciparum Malaria in African Infants and Young Children

Steffen Borrmann, Jean-François Faucher, Thierry Bagaphou, Michel A. Missinou, Ronald K. Binder, Sophia Pabisch, Philipp Rezbach, Pierre-Blaise Matsiegui, Bertrand Lell, Gerri Miller and Peter G. Kremsner
Clinical Infectious Diseases
Vol. 37, No. 11 (Dec. 1, 2003), pp. 1441-1447
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4483718
Page Count: 7
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Atovaquone and Proguanil versus Amodiaquine for the Treatment of Plasmodium falciparum Malaria in African Infants and Young Children
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Abstract

Malaria-related morbidity and mortality are greatest among young children in areas with high malaria transmission intensity. An open-label, randomized study was done to evaluate the efficacy and safety of the combination of atovaquone and proguanil formulated as pediatric-strength tablets (20 and 8 mg/kg of body weight, respectively, administered once daily for 3 days), compared with amodiaquine (10 mg/kg of body weight, once daily for 3 days), among children weighing ≥5 and <11 kg in Gabon. Two hundred patients aged 3-43 months were recruited. Use of atovaquone/proguanil resulted in a cure rate on day 28 of 95% (87 of 92 children), compared with 53% (41 of 78 children) for amodiaquine (difference, 42%; 95% CI, 30%-54%; P < .001). The incidence of adverse events was similar in both groups, and no serious adverse events were attributed to the use of atovaquone/proguanil. Atovaquone/proguanil was found to be highly effective and safe for the treatment of Plasmodium falciparum malaria in infants and young children weighing 5-10 kg in Africa.

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