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Evidence summaries

Atovaquone-Proguanil for Treating Uncomplicated Malaria

Atovaquone-proguanil appears to be more effective than chloroquine, amodiaquine, and mefloquine in the treatment of uncomplicated P. falciparum malaria. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 10 studies with a total of 2 345 subjects. The trials were conducted in four geographical regions. They were often small and with methodological problems, but they included comparisons across eight drugs.

Atovaquone-proguanil had fewer treatment failures by day 28 than chloroquine (RR 0.04, 95% CI 0.00 to 0.57; 27 participants, 1 trial), amodiaquine (RR 0.22, 95% CI 0.13 to 0.36; 342 participants, 2 trials), and mefloquine (RR 0.04, 95% CI 0.00 to 0.73; 158 participants, 1 trial). There were insufficient data to draw a conclusion for this outcome from comparisons with sulfadoxine-pyrimethamine (172 participants, 2 trials), halofantrine (205 participants, 1 trial), artesunate plus mefloquine (1063 participants, 1 trial), quinine plus tetracycline (154 participants, 1 trial), and dihydroartemisinin-piperaquine-trimethoprim-primaquine (161 participants, 1 trial). Adverse events were mainly common symptoms of malaria and did not differ in frequency between groups.

    References

    • Osei-Akoto A, Orton L, Owusu-Ofori SP. Atovaquone-proguanil for treating uncomplicated malaria. Cochrane Database Syst Rev 2005 Oct 19;(4):CD004529. [PubMed]

Primary/Secondary Keywords