antibioticsbooks

266 PART 6 Antiparasitic Drugs
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Important Facts
• Atovaquone is available as a suspension, while
atovaquone/proguanil is formulated as a tablet.
Bioavailability is rather low with both, but it is
enhanced substantially when given with food,
especially high-fat meals. Both agents should
be administered with food.
• In clinical trials of atovaquone in treating
mild-to-moderate Pneumocystis pneumonia
in patients intolerant of TMP/SMX, atovaquone
was slightly less effective than its comparators
(dapsone or pentamidine) but better
tolerated, leading to similar overall success
rates. Atovaquone should not be used in
patients with severe Pneumocystis pneumonia
or in patients whose GI absorption is thought
to be poor.
• Other than its cost, atovaquone/proguanil is a
favorable drug for malaria prophylaxis for travelers.
It is highly effective, well tolerated, active
against chloroquine-resistant Plasmodium, and
requires administration only one to two days
prior to travel, while in the malaria-endemic
area, and for seven days after return. Many other
agents used for malaria prophylaxis require
beginning the medication two weeks before
travel and continuing for four weeks afterward.
What They’re Good For
Atovaquone: Treatment of mild-to-moderate
Pneumocystis pneumonia and prophylaxis
against Pneumocystis in patients intolerant of
first-line therapy
Atovaquone/proguanil: Treatment of uncomplicated
malaria and prophylaxis against malaria