Malaria Treatment Failure with Atovaquone-Proguanil
Author Information
Author(s): Durand Rémy, Prendki Virginie, Cailhol Johann, Hubert Véronique, Ralaimazava Pascal, Massias Laurent, Bouchaud Olivier, Le Bras Jacques
Primary Institution: Hôpital Avicenne, Bobigny, France
Hypothesis
Is the standard dosage of atovaquone-proguanil sufficient for patients weighing over 100 kg?
Conclusion
The treatment failure in the patient was likely due to insufficient dosage of atovaquone-proguanil related to his weight.
Supporting Evidence
- Fewer than 25 cases of treatment failure with atovaquone-proguanil have been documented since its registration.
- The patient showed no signs of vomiting or diarrhea during treatment.
- Blood smears indicated a low level of parasitemia after treatment, but parasites were still present on day 28.
- Initial drug concentration was adequate, but treatment failed to clear the parasites.
Takeaway
If you weigh more than 100 kg, the usual malaria medicine might not work as well, so doctors need to pay extra attention.
Methodology
Case report of a patient treated with atovaquone-proguanil for malaria, including blood smears and drug concentration measurements.
Limitations
Only one case is reported, limiting generalizability.
Participant Demographics
A 39-year-old male traveler from Africa weighing 115 kg.
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website