Background: A widespread resistance of falciparum malaria to common antimalaria drugs is observed during the last years. Long-distance travel to high-risk destinations of falciparum malaria will contribute to increased exposition of travelers to highly resistant parasites.
Pharmacology: Malarone (GlaxoSmithKline) is a fixed combination of atovaquone and proguanil licensed for prophylaxis and treatment of falciparum malaria. Both atovaquone and proguanil demonstrate synergistic activity against liver and blood schizonts. Malarone is well tolerated with a low rate of side effects. Malarone has an excellent efficacy profile in nonimmune subjects.
Conclusions: Malarone appears to be a valuable alternative malaria prophylaxis in case of intolerance of other antimalaria drugs. Atovaquone/proguanil is effective in treating acute uncomplicated malaria caused by multiresistant strains of Plasmodium falciparum.