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Drugs for preventing malaria in travellers
Cochrane Reviews, 10/23/09

Jacquerioz FA et al. – This review was designed to assess the efficacy, safety, and tolerability of atovaquone–proguanil, doxycycline, and mefloquine (the three currently available chemoprophylaxis choices for regions with P. falciparum resistance) compared to each other, and also when compared to chloroquine–proguanil (an older drug combination) and to primaquine (a candidate for chemoprophylaxis)...Eight trials (4240 participants) met the inclusion criteria. There were differences in the common unwanted effects of the drugs which are currently available to prevent malaria, in adult and child travellers. However, the quality of evidence was overall low. Atovaquone–proguanil and doxycycline are the best tolerated regimens. Mefloquine has more adverse effects than other drugs, and these adverse effects are sometimes serious. However mefloquine may still be an appropriate choice for those travellers who have taken it previously, without any adverse events. Other factors should be considered by prescribers, in addition to tolerability: cost, ease of administration, possible drug–drug interactions, travel itinerary, and the additional protection that may be afforded by doxycycline against other infections, besides malaria.

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