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.
CITATION STYLE
Wichmann, O., Muehlen, M., Gruss, H., Mockenhaupt, F. P., Suttorp, N., & Jelinek, T. (2004). Malarone treatment failure not associated with previously described mutations in the cytochrome b gene. Malaria Journal, 3. https://doi.org/10.1186/1475-2875-3-14
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