Malaria Prophylaxis Using Azithromycin: A Double‐Blind, Placebo‐Controlled Trial in Irian Jaya, Indonesia | Zendy

Walter R. J. Taylor | Zendy; Thomas L. Richie | Zendy; David J. Fryauff | Zendy; Helena Picarima | Zendy; Colin Ohrt | Zendy; Douglas B. Tang | Zendy; David J. Braitman | Zendy; Gerald S. Murphy | Zendy; Hendra Widjaja | Zendy; Emiliana Tjitra | Zendy; Asep Ganjar | Zendy; Trevor R. Jones | Zendy; Hasan Basri | Zendy; Josh Berman | Zendy

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Malaria Prophylaxis Using Azithromycin: A Double‐Blind, Placebo‐Controlled Trial in Irian Jaya, Indonesia

Author(s) -

Walter R. J. Taylor,

Thomas L. Richie,

David J. Fryauff,

Helena Picarima,

Colin Ohrt,

Douglas B. Tang,

David J. Braitman,

Gerald S. Murphy,

Hendra Widjaja,

Emiliana Tjitra,

Asep Ganjar,

Trevor R. Jones,

Hasan Basri,

Josh Berman

Publication year - 1999

Publication title -

clinical infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.44

H-Index - 336

eISSN - 1537-6591

pISSN - 1058-4838

DOI - 10.1086/515071

Subject(s) - azithromycin , medicine , malaria prophylaxis , malaria , placebo , double blind , protozoal disease , clinical trial , immunology , alternative medicine , antibiotics , pathology , microbiology and biotechnology , biology

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.

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