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SPECIAL ARTICLES: Antimicrobial Drug Reviews

ANTIPARASITIC AGENT ATOVAQUONE

Infectious Diseases in Clinical Practice: March 2002 - Volume 11 - Issue 3 - p 185-186
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ANTIPARASITIC AGENT ATOVAQUONE

[Baggish AL and Hill DR. AAC 2002;46:1163]:

The authors review atovaquone, which is a naphthoquinone with activity against multiple parasites and P. carinii. Greatest interest has been for the use of this agent in the following setting:

  1. Treatment and prevention of P. carinii pneumonia
  2. Treatment and prevention of falciparum malaria
  3. Treatment of babesiosis
  4. Salvage treatment of toxoplasmosis.

With PCP, the drug is used alone. For falciparum malaria, it is combined with proguanil (Malarone), and babesiosis it is combined with azithromycin. The results of multiple trials for these conditions are summarized in Table 2.

TABLE 2
TABLE 2:
Atovaquone: therapeutic trials

Comment:

This is an unusual drug with an extraordinary spectrum of activity. Advantages include the oral formulation and limited side effects. The disadvantage is viability in absorption (with the need for concurrent high-fat meal) and the high cost. Compared to dapsone or sulfa-trimethoprim for PCP, atovaquone is 50–100 times more expensive. For malaria prophylaxis, the cost is comparable to mefloquine.

© 2002 Lippincott Williams & Wilkins, Inc.