atovaquone/proguanil / Generic mfg. - LARVOL DELTA

Atovaquone/proguanil use and zoster vaccination are associated with reduced Alzheimer's disease risk in two cohorts: implications for a latent Toxoplasma gondii mechanism. (PubMed, Brain Behav Immun) - "In exploratory analyses, the magnitude of the association between atovaquone-proguanil and subsequent dementia appeared to differ according to prior VZV vaccination status, suggesting a possible interaction between protozoal suppression and antiviral immunity. Together, these findings provide population-level evidence consistent with a latent T. gondii-related mechanism in AD pathogenesis, and highlight testable targets for future mechanistic and interventional research."

Journal • Alzheimer's Disease • CNS Disorders • Dementia • Herpes Zoster • Varicella Zoster

Artesunate-pyronaridine-atovaquone-proguanil and artesunate-fosmidomycin-clindamycin compared with standard artesunate-pyronaridine for the treatment of uncomplicated malaria (MultiMal): a randomised, controlled, clinical, phase 2 trial in Gabon and Ghana. (PubMed, Lancet Microbe) - "Antimalarial regimens of APAP and AFC have unique characteristics to tackle the development and spread of drug-resistant P falciparum malaria. Given that APAP and AFC were safe, well tolerated, and highly efficacious in this clinical phase 2 study, they constitute promising multidrug combination regimens for further clinical development."

Journal • P2 data • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Infectious Disease • Malaria • Peptic Ulcer

Congenital babesiosis in China: first molecularly confirmed case of vertical transmission of Babesia microti. (PubMed, Emerg Microbes Infect) - "Treatment with intravenous azithromycin and oral atovaquone/proguanil resulted in rapid clearance of parasitemia and resolution of anaemia. This first molecularly confirmed case of congenital B. microti transmission in China demonstrates vertical transmission from an asymptomatic mother. It underscores the need for heightened clinical suspicion in neonates with unexplained haemolytic anaemia in endemic regions and highlights critical gaps in access to essential anti-babesia therapies."

Journal • Hematological Disorders • Infectious Disease

Splenic accumulation of intact Plasmodium ovale sensu lato-infected red blood cells in a patient presenting with splenic rupture. (PubMed, PLoS Negl Trop Dis) - "A 35-year-old man had splenic rupture just after starting antimalarial treatment with atovaquone-proguanil followed by artesunate for acute Plasmodium ovale sensu lato infection. Spleen histology showed a 10-fold accumulation of intact P. ovale s.l.-infected erythrocytes in the spleen parenchyma compared to the general circulation. Infected erythrocytes also accumulated in small extra-splenic blood vessels, suggesting cytoadherence."

Journal • Infectious Disease

Appropriateness of malaria treatment according to World Health Organization criteria for severe malaria in a non-endemic country. (PubMed, Enferm Infecc Microbiol Clin (Engl Ed)) - "Antimalarial treatments were mostly adequate, especially in severe cases. The most common reason for artesunate overuse was the presence of thrombocytopenia, which is not included in the WHO criteria for severe malaria."

Journal • Chronic Kidney Disease • Hematological Disorders • Infectious Disease • Malaria • Nephrology • Renal Disease • Thrombocytopenia

Accessibility to antimalarials in Spanish hospitals: analysis of a national survey. (PubMed, Malar J) - "The study highlights substantial variability and critical delays in antimalarial drug availability across Spanish hospitals. Enhancing access requires national stockpiling strategies, broader implementation of standardized treatment protocols, and improved procurement systems. These measures are vital to ensure timely treatment and reduce morbidity associated with imported malaria."

Journal • Infectious Disease • Malaria

Treatment of Plasmodium falciparum malaria in the nonendemic setting: a narrative review of toxicity, failure and emerging resistance. (PubMed, Expert Rev Anti Infect Ther) - "For more than 15 years, artemisinin-based combination therapy (ACT) and atovaquone-proguanil have been recommended as treatment of Plasmodium falciparum malaria in most nonendemic countries...This population may also be more vulnerable to complications of malaria as reduced susceptibility to key antimalarials spreads. We propose specific adaptations to the management of malaria in travelers, with a focus on structured clinical follow-up to detect toxicity and failure, and on systematic genomic surveillance in concert with existing initiatives in endemic countries."

Journal • Review • Hematological Disorders • Infectious Disease • Malaria • Obesity

Malaria in an Non-Endemic Setting: A Retrospective Study of Cases in New York City (ASTMH 2025) - "Artemether-lumefantrine (50.2%) and atovaquone-proguanil (34.6%) were the most common treatments, with intravenous artesunate used in 14.3%. While most cases are promptly identified, delays in testing and treatment persists. These findings emphasize the need for enhanced provider awareness and clinical vigilance in non-endemic areas."

Late-breaking abstract • Retrospective data • Infectious Disease • Malaria

WITHDRAWN Population pharmacokinetics of atovaquone in African children with Plasmodium falciparum malaria and treated with artemether-lumefantrine + atovaquone-proguanil (ASTMH 2025) - "According to this model, the CI90 for the maximum observed TBA with the 125 mg unitary ATV dose was [40%-70%]. A model relating ATV concentration and treatment efficacy will also be produced later."

Clinical • Late-breaking abstract • PK/PD data • Infectious Disease • Malaria

Efficacy and Safety of Artemether-Lumefantrine Plus Atovaquone-Proguanil for Uncomplicated Malaria in African Children: A Multicentre Phase 3 Trial (ASTMH 2025) - "Despite a higher incidence of early vomiting, the TACT regimen showed a trend toward reduced late treatment failures. These findings support the idea of evaluating AL+AP in areas of artemisinin resistance to delay or prevent the spread of antimalarial resistance in sub-Saharan Africa."

Clinical • Late-breaking abstract • P3 data • Anemia • Hematological Disorders • Infectious Disease • Malaria

Artemether-lumefantrine or artemether-lumefantrine plus atovaquone-proguanil treatment reduces Plasmodium falciparum crt76T but selects dhfr(51, 59, and 108) triple mutant in Faladie, Mali (ASTMH 2025) - "Our preliminary results showed a reduction of Pfcrt 76T mutation proportion after treatment with artemether-lumefantrine or artemether-lumefantrine plus atovaquone-proguanil and a selection of dhfr triple mutant. If this result is validated, this triple ACT can alleviate resistance to chloroquine."

Infectious Disease • Malaria • ABCB1 • DHFR

Comprehensive profiling of ex vivo drug susceptibility of clinical isolates of Plasmodium vivaxin Southeast Asia (ASTMH 2025) - "Fresh P. vivax clinical isolates (N = 997) from six provinces in Cambodia and Thailand from 2019 - 2023 were evaluated using an ex vivo culture growth inhibition assay against a panel of 14 antimalarial drugs: dihydroartemisinin (DHA), artemisinin (AS), mefloquine (MQ), quinine (QN), chloroquine (CQ), doxycycline (DOX), proguanil (PG), atovaquone (ATQ), lumefantrine (LUM), cycloguanil (CYC), tafenoquine (TQ), primaquine (PQ), piperaquine (PPQ) and pyronaridine (PND). This study represents one of the largest systematic efforts to collect ex vivo drug susceptibility data from P. vivax isolates in Southeast Asia. Our findings demonstrate the feasibility of carrying out systematic monitoring of P. vivax drug susceptibility and highlight the importance of continued monitoring in the region."

Preclinical • Infectious Disease • Malaria

Systematic screening Identifies medication and disease factors associated with Schizophrenia risk. (PubMed, Brain Behav Immun) - "Among all medication classes screened, strong protective associations were detected for specific antimicrobials, notably atovaquone/proguanil, clindamycin, and ophthalmic fluoroquinolones. Nonsteroidal anti-inflammatory drugs, particularly COX-2 inhibitors, were also linked to reduced SCZ risk, whereas neomycin, tramadol, and desmopressin were associated with increased risk. Key associations were confirmed within TriNetX with high statistical significance. These observational findings, reproduced across two national cohorts, are hypothesis-generating and may reflect multiple, non-exclusive mechanisms, including antimicrobial, anti-inflammatory, and microbiome-related pathways, with T. gondii elimination through antiprotozoal activity representing one compelling explanatory hypothesis that warrants further investigation."

Journal • CNS Disorders • Infectious Disease • Inflammation • Mental Retardation • Ophthalmology • Psychiatry • Schizophrenia

Complete attenuation of Plasmodium falciparum sporozoites by atovaquone-proguanil. (PubMed, EMBO Mol Med) - "2/8 and 2/10 of vaccinees, respectively, were protected when challenged with 3.2 × 103 PfSPZ 10 weeks later, inferior to PfSPZ-CVac (chloroquine/CQ) that allows in-host replication. Comparative analysis of responses to 228 Pf proteins revealed that protection with PfSPZ-CVac (CQ) was associated with antibodies to two liver-stage antigens (LISP2, LSA1) and a multi-stage antigen (PfMSP5), but not to the major surface protein PfCSP. The complete arrest of high numbers of Pf sporozoites by single-dose AP should allow a significant dose-frequency reduction of the current daily AP malaria chemoprophylaxis regimen."

Journal • Infectious Disease • Malaria • CD8

Human monoclonal antibody MAM01 for protection against malaria in adults in the USA: a first-in-human, phase 1, dose-escalation, double-blind, placebo-controlled, adaptive trial. (PubMed, Lancet Infect Dis) - P1 | "MAM01 was well tolerated, met safety targets, and showed clinical proof-of-principle by eliciting protection in malaria-naive adults using the controlled human malaria infection model. Progress driving down the cost of goods coupled with dose selection within target populations will dictate the feasibility of malaria monoclonal antibody deployment."

First-in-human • Journal • P1 data • Infectious Disease • Malaria

Recurrent Malaria with Plasmodium vivax: A Case Report and Brief Review of the Literature. (PubMed, Trop Med Infect Dis) - "The patient was treated with doxycycline and atovaquone-proguanil...Despite receiving primaquine as radical cure after the first Plasmodium vivax malaria relapse, a second relapse occurred... Malaria rarely occurs in non-endemic areas; it should be considered in patients with compatible travel history and symptoms. Given the high relapse potential of Plasmodium vivax, accurate species identification is critical to guide appropriate long-term management."

Journal • Hematological Disorders • Infectious Disease • Malaria • Musculoskeletal Pain • Pain • Thrombocytopenia

Evaluation of in vitro drug-drug interactions of ivermectin and antimalarial compounds. (PubMed, Malar J) - "Several of the commonly used antimalarial drugs, are mostly or in part metabolized by CYP3A4 and showed a notable DDI effect on the in vitro metabolism of ivermectin. This could potentially lead to clinically important pharmacokinetic and pharmacodynamic DDIs if co-administered, and needs to be evaluated in prospective clinical trials."

Journal • Preclinical • Infectious Disease • Malaria • CYP3A4

Atovaquone-proguanil and reduced digestive cancer risk: a Toxoplasma gondii connection. (PubMed, Gut Microbes) - "These findings suggest T. gondii may be an overlooked microbial risk factor for digestive cancers, and that A-P may offer chemopreventive effects through antiparasitic activity. Prospective studies are needed to evaluate its preventive potential."

Journal • Retrospective data • Colorectal Cancer • Gastrointestinal Cancer • Infectious Disease • Oncology • Pancreatic Cancer • Solid Tumor

The role of emergency departments in the treatment of imported severe and uncomplicated malaria - a retrospective monocentric observational study in a German university hospital. (PubMed, Acta Trop) - "ED play a crucial role in the care of patients with malaria. Our work presents for the first time extensive and detailed data on diagnosis, patient characteristics, laboratory and clinical parameters, therapy, and outcomes of these patients in the ED of a large German university hospital."

Journal • Observational data • Retrospective data • Infectious Disease • Malaria

False-Positive Malaria Rapid Diagnostic Test Likely Due to African Tick Bite Fever: A Case Report. (PubMed, Reports (MDPI)) - "Case Presentation: 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-film blood 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."

Journal • Infectious Disease • Malaria

Associations Between Antiprotozoal Treatments and Reduced Mortality Across Populations Suggest That Protozoal Colonization May Contribute Significantly to Human Mortality and Age-Related Morbidity. (PubMed, medRxiv) - "This screen identified two antiprotozoal agents, atovaquone-proguanil and mefloquine, as strongly associated with increased longevity (odds ratios for 10-year mortality: 0.43 and 0.32; FDR = 0.0002 and 0.0001, respectively). We validated these associations in the U.S.-based TriNetX federated network, confirming that these two antiprotozoals, along with nirmatrelvir-ritonavir-a medication used to prevent severe COVID-19 outcomes and possessing antiprotozoal properties-were associated with significantly reduced mortality and a lower incidence of major age-related conditions, including diabetes mellitus, cardiovascular and cerebrovascular diseases, renal insufficiency, dementia, pulmonary disease, liver disease, and malignancies...Taken together, these findings suggest that elimination of protozoal parasites-notably Toxoplasma gondii - may significantly reduce human age-related morbidity and mortality while increasing the risk of specific auditory, ophthalmic, and..."

Journal • Alzheimer's Disease • Cardiovascular • CNS Disorders • Dementia • Dermatology • Dermatopathology • Diabetes • Hepatology • Immunology • Infectious Disease • Lichen Planus • Metabolic Disorders • Nephrology • Novel Coronavirus Disease • Oncology • Ophthalmology • Otorhinolaryngology • Pulmonary Disease • Renal Disease • Respiratory Diseases • Sjogren's Syndrome • Vascular Neurology

Missed Until Critical: Unravelling the Mystery of Persistent Hemolysis With a Definitive Diagnosis of Babesiosis. (PubMed, Cureus) - "From these tests, we were able to diagnose her with a malarial infection that was treated with quinine and doxycycline, then atovaquone/proguanil following worsening infection...Clinically, she improved after the transition to atovaquone and azithromycin, but unfortunately, she was readmitted due to persistent hemolysis and pneumonia requiring extended antibiotic therapy and supportive care...It raises awareness among clinicians regarding tick-borne illnesses in endemic regions, as in this case, to minimize delays in diagnosis and treatment. This case also shows how early recognition and treatment are crucial to prevent severe complications of babesiosis, including septic shock, especially in the immunocompromised and elderly population."

Journal • Cardiovascular • Critical care • Dyslipidemia • Hematological Disorders • Hypertension • Immunology • Infectious Disease • Malaria • Pneumonia • Respiratory Diseases • Septic Shock • Thrombocytopenia

Malaria recrudescence after artemether-lumefantrine treatment in travellers- a hospital-based observational study and literature review. (PubMed, Trop Dis Travel Med Vaccines) - "Recrudescence after AL treatment is rare among travellers, and was associated with diarrhoea, which might cause malabsorption. When recrudescence occurs, retreatment with AL is effective."

Journal • Observational data • Infectious Disease • Malaria

Malaria: past, present, and future. (PubMed, Signal Transduct Target Ther) - "The FDA-approved regimens like Artemether-Lumefantrine, Atovaquone-Proguanil, and Primaquine are discussed, and their benefits and limitations are highlighted, especially in terms of drug resistance. Perspectives in the development of novel vaccines and new drugs, such as Sevuparin, Imatinib, and Cipargamin, and combination therapies with promise in overcoming resistance has been proposed. Overall, this review provides a detailed summary of the latest progress in malaria research and emphasizes the need for continuous monitoring and innovation in malaria treatment."

Journal • Review • Infectious Disease • Malaria

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 • Hematological Disorders • Hematological Malignancies • Hypertension • Infectious Disease • Malaria • Metabolic Disorders • Multiple Myeloma • Musculoskeletal Pain • Nephrology • Oncology • Pain • Pneumonia • Renal Disease • Respiratory Diseases • Septic Shock