Malarone treatment failure not associated with previously described mutations in the cytochrome b gene

Abstract Malarone ® (atovaquone-proguanil) is an effective drug for the treatment and prophylaxis of multidrug-resistant falciparum malaria. However, first cases of resistance have been reported, which are associated with mutations at codon 268 of the parasite's cytochrome b gene. We report the...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Mockenhaupt Frank P, Gruss Holger, Muehlen Marion, Wichmann Ole, Suttorp Norbert, Jelinek Tomas
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2004
Subjects:
Arctic medicine. Tropical medicine
RC955-962
Infectious and parasitic diseases
RC109-216
Arctic
Online Access:https://doi.org/10.1186/1475-2875-3-14
https://doaj.org/article/e9bbd17f350e41c0930fe0365ed1688a
Description
Summary:Abstract Malarone ® (atovaquone-proguanil) is an effective drug for the treatment and prophylaxis of multidrug-resistant falciparum malaria. However, first cases of resistance have been reported, which are associated with mutations at codon 268 of the parasite's cytochrome b gene. We report the first case of Malarone ® treatment failure from Central Africa. Drug concentration was well within curative range. Pre- and post-treatment Plasmodium falciparum isolates revealed codon 268 wild-type alleles, and no other mutations of the putative atovaquone-binding domain. These findings illustrate the spread of atovaquone-proguanil-resistance in Africa and question the usefulness of codon 268 as the only target for the surveillance of its emergence.

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