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

• 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

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.