atovaquone/proguanil / Generic mfg. - LARVOL DELTA

Infectious Pair in Sin City: COVID-19 and Malaria Co-infection in a Las Vegas Case (ATS 2025) - "Case: A 67-year-old male with a history of multiple myeloma (on bortezomib/lenalidomide), hypertension, and coronary artery disease presented with altered mental status...Treatment included atovaquone/proguanil and intravenous artesunate for 3 days...Ceftriaxone and vancomycin were administered empirically for pneumonia...In conclusion, clinicians should consider Malaria in the differential diagnosis of sepsis in travelers from endemic areas. Malaria prophylaxis is crucial, especially for immunocompromised patients."

Clinical • Acute Kidney Injury • Anemia • Cardiovascular • Coronary Artery Disease • Cough • Gastrointestinal Disorder • Hematological Disorders • Hematological Malignancies • Hypertension • Infectious Disease • Malaria • Metabolic Disorders • Multiple Myeloma • Musculoskeletal Pain • Nephrology • Novel Coronavirus Disease • Oncology • Pain • Pneumonia • Renal Disease • Respiratory Diseases • Septic Shock

Which trial do we need? A randomised controlled study to compare the protective efficacy of early post-exposure discontinuation versus standard atovaquone-proguanil malaria prophylaxis in a human Plasmodium falciparum challenge model. (PubMed, Clin Microbiol Infect) - No abstract available

Journal • Infectious Disease • Malaria

Congenital infection with Plasmodium malariae: a rare case of intrauterine transmission in Germany. (PubMed, Malar J) - "The case highlights the diagnostic and therapeutic complexities of life-threatening congenital P. malariae infections in non-endemic countries. It underlines the importance of clinicians' awareness of maternal travel or migration history and individualized treatment strategies. The increasing global mobility necessitates updated guidelines for congenital malaria management even for less likely P. malariae infections. Prophylactic measures, early recognition, and multidisciplinary management are critical for improving outcomes for such rare but severe presentations and their long-lasting complications. Possible comprehensive neonatal malaria screening in high-risk populations should be considered in the future."

Journal • CNS Disorders • Critical care • Developmental Disorders • Epilepsy • Hematological Disorders • Hepatology • Infectious Disease • Malaria • Pediatrics • Thrombocytopenia

Case report: First autochthonous Babesia vulpes infection in a dog from Italy. (PubMed, Front Vet Sci) - "An initial treatment with imidocarb dipropionate was only partially effective, while resolution of the infection was reached afterward with a combination of Malarone® and azithromycin therapy. To the authors' knowledge, this report describes the first case of B. vulpes infection in a dog in Italy."

Journal • Hematological Disorders • Infectious Disease • Pain • Thrombocytopenia

Treatment of avian malaria in captive African penguins (Spheniscus demersus) by the combination of atovaquone and proguanil hydrochloride. (PubMed, Int J Vet Sci Med) - "However, the persistence of Plasmodium relictum in one case highlights the need for careful post-treatment monitoring to prevent recurrence or reinfection. The study underscores the importance of developing tailored antimalarial protocols for captive birds to enhance conservation efforts and mitigate the risks posed by avian malaria."

Journal • Infectious Disease • Malaria

Travellers' adherence to atovaquone/proguanil malaria chemoprophylaxis after return from endemic areas. (PubMed, Travel Med Infect Dis) - "Non-adherence was high during the seven days after return. Travellers preferred an alternative AP chemoprophylaxis regimen, allowing them to discontinue upon return. Future research shall be conducted to investigate whether AP could be discontinued upon return."

Journal • Infectious Disease • Malaria

Efficacy, Safety, and PK of M5717 in Combination With Pyronaridine as Chemoprevention in Adults and Adolescents With Asymptomatic Plasmodium Falciparum Infection (CAPTURE-2) (clinicaltrials.gov) - P2 | N=192 | Completed | Sponsor: Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany | Recruiting ➔ Completed

Trial completion • Infectious Disease • Malaria

A Study to Evaluate Antimalarial Activity and Safety of MK-7602 in Healthy Adults (MK-7602-003) (clinicaltrials.gov) - P1 | N=16 | Completed | Sponsor: Merck Sharp & Dohme LLC | Recruiting ➔ Completed | N=42 ➔ 16

Enrollment change • Trial completion • Infectious Disease • Malaria

Plasmodium ovale: Exploring an Atypical Presentation. (PubMed, Cureus) - "The patient was treated with three doses of intravenous artesunate, followed by a three-day course of oral atovaquone-proguanil. After G6P deficiency and sickle cell tests were found to be negative, he was started on primaquine for 14 days to eradicate liver hypnozoites. The patient had a favorable outcome; the pancytopenia resolved, and he remained stable and was discharged home."

Journal • Hematological Disorders • Infectious Disease • Malaria • Pain • Septic Shock

False-positive Malaria Rapid Diagnostic Test due to African Tick Bite fever (ASTMH 2024) - "We describe a case of a febrile returned traveler to South Africa whose prompt initial diagnostic work-up was notable for a false-positive malaria rapid diagnostic test (RDT), and who nevertheless responded quickly to oral atovaquone-proguanil, despite an ultimate diagnosis of African tick bite fever. Subsequent RDT and malaria thick- and thin blood film examination failed to corroborate a diagnosis of malaria and all other microbiological testing other than rickettsial serology remained non-contributory. The case presented highlights important points regarding diagnostic test performance characteristics and premature diagnostic closure."

Late-breaking abstract • CNS Disorders • Infectious Disease • Malaria

Exposure to malaria prophylactic medication prescriptions during pregnancy in women receiving care in the US Military Health System from 2011-2023 (ASTMH 2024) - "Exposure was defined by prescription for mefloquine, chloroquine, doxycycline, tafenoquine, primaquine and/or atovaquone/proguanil with days of supply overlapping with pregnancy. As the proportion of women in the US military continues to increase, so too will the need for safe and efficacious chemoprophylaxis options for use during pregnancy. Further study of maternal, fetal and infant outcomes of pregnancies exposed to atovaquone-proguanil, considering duration and trimester of exposure, is warranted."

Clinical • Late-breaking abstract • Infectious Disease • Malaria

Partial clearance of pre-established Plasmodium falciparum infection in mosquitoes by mimicking a bloodmeal on treated patients with Artemether+Lumefantrine + Atovaquone-Proguanil (ASTMH 2024) - "Further analysis including correlation with drug dosage, mosquito survival and quantification of sporozoites in the salivary glands is ongoing. These results highlight a benefit of triple ACT containing AP as when treated patients are bitten by infected mosquitoes, they may be partially “cured” of the infection and therefore reduce transmission."

Clinical • Infectious Disease • Malaria

The safety, efficacy and transmission blocking effect of artemether-lumefantrine +atovaquone-proguanil for uncomplicated malaria (ASTMH 2024) - No abstract available

Clinical • Infectious Disease • Malaria

Phase II evaluation of artesunate-pyronaridine+atovaquone-proguanil and artesunate+fosmidomycin+clindamycin for the treatment of uncomplicated malaria (ASTMH 2024) - No abstract available

P2 data • Infectious Disease • Malaria

2 - Can We Expect Triple/Multiple Artemisinin-Based Combination Therapies for Malaria in the Near Future? (ASTMH 2024) - "Artemether-lumefantrine (AL) is the most widely used ACT, accounting for >70% of ACT use...New antimalarial drugs may not come to the market within the next 5 years and one of the leading candidates, ganaplacide, is currently combined with lumefantrine...The Development of Triple Artemisinin-based Combination Therapies (DeTACT project), the ArteSunate-Amodiaquine-Atovaquone-Proguanil (ASAAP) consortium and the Multi-drug combination therapies to prevent Malaria drug resistance (MULTIMAL) consortium have been working TACTs and MDACTs to be primarily deployed in pediatric populations in African countries...The DeTACT clinical trial is complete and final results on safety, tolerability and efficacy of AL+amodiaquine (AL+AQ) and artesunate-mefloquine+piperaquine from eight African countries will be presented...The ASAAP consortium’s evaluation of clinical efficacy and transmission blocking potential of AL+atovaquone-proguanil in five African countries will be presented...."

Combination therapy • Infectious Disease • Malaria • Pediatrics

Characteristics of imported and domestic malaria cases in Gyeonggi Province, Republic of Korea. (PubMed, Epidemiol Health) - "For domestic cases, chloroquine combined with primaquine was the most commonly prescribed treatment (77.0%), while atovaquone-proguanil was frequently used for imported cases (25.9%). The overall number of reported malaria cases declined following a sharp decrease in imported cases in 2020 and 2021. Despite a decreasing trend in malaria cases reported in Gyeonggi Province, imported cases exhibited higher hospitalization rates and different antibiotic prescription and treatment patterns, reflecting the presence of a different malarial species."

Journal • Infectious Disease • Malaria

Severe cutaneous adverse drug reaction to atovaquone/proguanil. (PubMed, J Travel Med) - "Side effects most commonly include headaches and gastrointestinal symptoms. Nevertheless, physicians should be aware of possible rare severe cutaneous adverse reactions, in order to facilitate the diagnosis and interrupt the drug rapidly if suspected."

Adverse drug reaction • Journal • Gastrointestinal Disorder • Infectious Disease • Malaria • Pain

SEVERE MALARIA COMPLICATED BY NONCARDIOGENIC PULMONARY EDEMA: WHEN HYPOPARASITEMIA PROVIDES FALSE REASSURANCE (CHEST 2024) - "She was treated initially with 1.5 Liters of IVF, Tylenol, and lorazepam 1 mg and was started on PO Atovaquone-Proguanil combination. This case highlights the importance of assessing different prognostic markers when treating for malaria in order to provide adequate therapy in a timely manner. Similarly, it warrants being vigilant with volume repletion given high risk of pulmonary edema in setting of increased capillary permeability[3]."

Acute Respiratory Distress Syndrome • Anemia • Cardiovascular • CNS Disorders • Epilepsy • Fatigue • General Anxiety Disorder • Heart Failure • Hematological Disorders • Infectious Disease • Malaria • Nephrology • Psychiatry • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Thrombocytopenia

Successful Transmammary Treatment of Babesia gibsoni Infection in Newborn Puppies after the Administration of Malarone®, Azithromycin, and Artesunate to a Lactating Dam. (PubMed, Pathogens) - "By day 77 after birth, three out of five positive puppies showed negative PCR tests for B. gibsoni, indicating successful treatment through breast milk during nursing. In the two remaining positive puppies, therapy was started and parasitemia was successfully eliminated."

Journal • Infectious Disease

Efficacy, Safety, and PK of M5717 in Combination With Pyronaridine as Chemoprevention in Adults and Adolescents With Asymptomatic Plasmodium Falciparum Infection (CAPTURE-2) (clinicaltrials.gov) - P2 | N=192 | Recruiting | Sponsor: Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany | Trial completion date: Apr 2024 ➔ Nov 2024 | Trial primary completion date: Apr 2024 ➔ Nov 2024

Combination therapy • Trial completion date • Trial primary completion date • Infectious Disease • Malaria

A randomized, open-label two-period crossover pilot study to evaluate the relative bioavailability in the fed state of atovaquone-proguanil (Atoguanil™) versus atovaquone-proguanil hydrochloride (Malarone®) in healthy adult participants. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - P1 | "Both drugs were well tolerated with no safety concerns. ClinicalTrials.gov: NCT04866602 (April 26th, 2021)."

Journal • Infectious Disease • Malaria

Late Parasitological Failure and Subsequent Isolated Gametocytemia of Uncomplicated Plasmodium falciparum Malaria in a Returned Traveler From Ghana, 2023. (PubMed, J Korean Med Sci) - "The patient was treated with intravenous artesunate followed by atovaquone/proguanil...Suspecting treatment failure, the patient was administered intravenous artesunate and doxycycline for seven days and then artemether/lumefantrine for three days. Blood smear was negative for asexual parasitemia after re-treatment but positive for gametocytemia until day 101 from the initial diagnosis. Overall, this case highlights the risk of late parasitological failure in patients with imported uncomplicated falciparum malaria."

Journal • Infectious Disease • Malaria • Pain

Tafenoquine for Relapsing Babesiosis: A Case Series. (PubMed, Clin Infect Dis) - "Tafenoquine can be a useful adjunct for the treatment of highly immunocompromised patients experiencing relapsing babesiosis caused by B. microti."

Journal • Infectious Disease • Malaria

COMPARATIVE EFFECT OF FOUR ANTIMALARIAL TREATMENTS ON HAEMATOCRIT IN CHILDREN IN SOUTHWEST OF NIGERIA (ESPID 2024) - "Change in haematocrit level from baseline through 28 days follow up period were compared among children treated with artemether-lumefantrine (82), atovaquone-proguanil (41), artesunate-amodiaquine (156) and chloroquine (34). Conclusions/Learning Points All children experienced increases in haematocrit after treatment, artemether-lumefantrine appearing to result in a greater increase in haematocrit than other antimalarial drugs. Children who are more susceptible to haemolyze during and after malarial infection such as Sickle Cell Disease and G6PD deficiency patients might benefit more from using the artemether-lumefantrine combination than the other antimalarial drugs in the Nigerian market."

Clinical • Anemia • Genetic Disorders • Hematological Disorders • Infectious Disease • Malaria • Metabolic Disorders • Sickle Cell Disease

Catching Flights and Malaria (ATS 2024) - "Empiric treatment for malaria, including Atovaquone-Proguanil, Doxycycline, Metronidazole, and Ceftriaxone, was initiated due to clinical suspicion...Artesunate and Artemether-Lumefantrine inhibit parasite replication through oxidative stress and inhibition of protein and nucleic acid synthesis...Additionally, it suggests the potential development of Malarial ARDS and, notably, COP as rare but crucial complication to consider in malaria-endemic regions. The successful application of FDA-approved drugs in this case underscores their therapeutic value in managing severe malaria in the United States."

Acute Kidney Injury • Acute Respiratory Distress Syndrome • Anemia • CNS Disorders • Fatigue • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Infectious Disease • Malaria • Nephrology • Otorhinolaryngology • Pain • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • Thrombocytopenia