ANTIMALARIAL ACTIVITY OF THE TRIPLE COMBINATION OF PROGUANIL, ATOVAQUONE AND DAPSONE

The combination of proguanil and atovaquone has been shown to be more effective in curing drug-resistant infections of falciparum malaria th an atovaquone or proguanil alone. Our current study sought to determin e whether the antimalarial activity could be increased by adding dapso ne. Plasma samples, obtained from individuals 4-72 h after proguanil-a tovaquone administration, were 2-3 times more active against Plasmodiu m falciparum in vitro when dapsone was added to them. The enhanced act ivity of the combination of proguanil, atovaquone and dapsone is proba bly due to the combined activity of two synergistic combinations: prog uanil-atovaquone and cycloguanil (metabolite of proguanil)-dapsone. Th ese findings suggest that further studies are needed to evaluate the c linical value of the triple drug combination of proguanil, atovaquone and dapsone in the treatment of multidrug resistant malaria. (C) 1997 Elsevier Science B.V.