• R Blondé, J Naudin, Z Bigirimana, L Holvoet, O Fenneteau, C Vitoux, O Bourdon, F Angoulvant, M Lorrot, E D'Ortenzio, A Bourrillon, J Le Bras, S Matheron, and A Faye.
• Service de pédiatrie générale, hôpital Robert-Debré, 48, boulevard Serurier, 75019 Paris, France.
• Arch Pediatr. 2008 Mar 1; 15 (3): 245-52.

UnlabelledOnly few drugs for uncomplicated Plasmodium falciparum malaria are available in children. Atovaquone-proguanil is a recent antimalarial drug licensed in France for the uncomplicated P. falciparum malaria in adults. Few paediatric studies have evaluated atovaquone-proguanil in children for uncomplicated malaria in endemic area, but no study have evaluated this treatment for imported malaria.ObjectiveTo evaluate treatment by atovaquone-proguanil for uncomplicated and imported P. falciparum malaria in children.MethodsWe retrospectively evaluated the tolerance and the efficacy of atovaquone-proguanil in the children admitted in Robert-Debré Hospital (Paris) for a P. falciparum malaria. From January 2004 to December 2005, 48 children with a median age of 7,5 years (IQR 4-11) were treated with atovaquone-proguanil for a uncomplicated P. falciparum malaria, except for 5 children who had an isolated hyperparasitemia greater or equal to 5%.ResultsAtovaquone-proguanil was stopped for 3/48 children because of vomiting. Fever resolved in all the children between Day 3 and 7, following the beginning of the treatment. One child, with a favourable outcome, had a positive parasitemia at Day 4 equal to the initial parasitemia (0,1%). No late therapeutic failure was observed among the 24 children evaluated up to one month after starting treatment.ConclusionAtovaquone-proguanil is an efficient and well-tolerated antimalarial treatment for uncomplicated P. falciparum malaria in children. The risk of vomiting should lead to a systematic initial hospitalisation of children treated with atovaquone-proguanil.

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