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Malaria Prophylaxis Using Azithromycin: A Double-Blind, Placebo-Controlled Trial in Irian Jaya, Indonesia
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Malaria Prophylaxis Using Azithromycin: A Double-Blind, Placebo-Controlled Trial in Irian Jaya, Indonesia
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Journal Article
Malaria Prophylaxis Using Azithromycin: A Double-Blind, Placebo-Controlled Trial in Irian Jaya, Indonesia
1999
Overview
New drugs are needed for preventing drug-resistant Plasmodium falciparum malaria. The prophylactic efficacy of azithromycin against P. falciparum in malaria-immune Kenyans was 83%. We conducted a double-blind, placebo-controlled trial to determine the prophylactic efficacy of azithromycin against multidrug-resistant P. falciparum malaria and chloroquine-resistant Plasmodium vivax malaria in Indonesian adults with limited immunity. After radical cure therapy, 300 randomized subjects received azithromycin (148 subjects, 750-mg loading dose followed by 250 mg/d), placebo (77), or doxycycline (75, 100 mg/d). The end point was slide-proven parasitemia. There were 58 P. falciparum and 29 P. vivax prophylaxis failures over 20 weeks. Using incidence rates, the protective efficacy of azithromycin relative to placebo was 71.6% (95% confidence interval [CI], 50.3–83.8) against P. falciparum malaria and 98.9% (95% CI, 93.1–99.9) against P. vivax malaria. Corresponding figures for doxycycline were 96.3% (95% CI, 85.4–99.6) and 98% (95% CI, 88.0–99.9), respectively. Daily azithromycin offered excellent protection against P. vivax malaria but modest protection against P. falciparum malaria.
Publisher
The University of Chicago Press,University of Chicago Press
Subject
/ Adult
/ Animals
/ Anti-Bacterial Agents - pharmacology
/ Anti-Bacterial Agents - therapeutic use
/ Antibiotics. Antiinfectious agents. Antiparasitic agents
/ Antimalarials - therapeutic use
/ Azithromycin - therapeutic use
/ Biological and medical sciences
/ Dosage
/ Female
/ Humans
/ Malaria
/ Malaria, Falciparum - epidemiology
/ Malaria, Falciparum - prevention & control
/ Malaria, Vivax - epidemiology
/ Malaria, Vivax - prevention & control
/ Male
/ Pharmacology. Drug treatments
/ Placebos
/ Soldiers
