Abstract | BACKGROUND:
Atovaquone/proguanil in Europe is only licensed for 4 weeks of travel. Data on its long-term tolerability in nonimmune travelers are scarce. METHODS: We prospectively studied adverse reactions reported by long-term travelers using atovaquone/proguanil among a population intolerant to mefloquine. The average length of atovaquone/proguanil use was 9 weeks (4.5 to 34 weeks). Adverse events were recorded on a regular questionnaire. Travelers rated complaints as: (1) mild, not interfering with their daily activities; (2) moderate, causing interference, such as canceling a trip or being confined to the hotel; or (3) severe, causing a visit to a doctor or clinic. Hospital admission was classified as category 3 and specified. We then compared our data with those on adverse reactions from 2 large multicenter studies of atovaquone/proguanil in nonimmune travelers. RESULTS: One hundred and fifty-four subjects used atovaquone/proguanil for a total of 1538 weeks. Diarrhea was the most common ailment (18%). Further complaints were abdominal pain (mild 4%, moderate 5%, severe 2%), headache (mild 4%, moderate 4%, severe 1%), dizziness (mild 3%, moderate 1%, severe 1%), and insomnia (mild 6%, moderate 0%, severe 0%). Two subjects of 154 (1%) discontinued prophylaxis, both due to diarrhea. Nobody was admitted to hospital. No case of malaria was reported. Comparison with data from previous, larger atovaquone/proguanil studies shows that the adverse events reported by the long-term atovaquone/proguanil users are no different in type and frequency of occurrence to those travel-related health problems normally encountered in the Tropics. CONCLUSIONS:
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Authors | David Overbosch |
Journal | Journal of travel medicine
(J Travel Med)
Vol. 10 Suppl 1
Pg. S16-20; discussion S21-3
(May 2003)
ISSN: 1195-1982 [Print] England |
PMID | 12737756
(Publication Type: Journal Article)
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Chemical References |
- Antimalarials
- Drug Combinations
- Naphthoquinones
- atovaquone, proguanil drug combination
- Proguanil
- Atovaquone
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Topics |
- Antimalarials
(administration & dosage, adverse effects)
- Atovaquone
- Drug Combinations
- Endemic Diseases
- Europe
(epidemiology)
- Female
- Humans
- Longitudinal Studies
- Malaria
(epidemiology, prevention & control)
- Male
- Naphthoquinones
(administration & dosage, adverse effects)
- Product Surveillance, Postmarketing
- Proguanil
(administration & dosage, adverse effects)
- Prospective Studies
- Surveys and Questionnaires
- Travel
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