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Our recent report of dihydroartemisinin-piperaquine failure to treatPlasmodium falciparum infections in Cambodia adds new urgency to the search for alternative treatments. Despite dihydroartemisinin-piperaquine failure, and higher piperaquine 50% inhibitory concentrations (IC50 s) following reanalysis than those previously reported,P. falciparum remained sensitive to atovaquone (ATQ)in vitro . There were no point mutations in theP. falciparum cytochromeb ATQ resistance gene. Mefloquine, artemisinin, chloroquine, and quinine IC50 s remained comparable to those from other recent reports. Atovaquone-proguanil may be a useful stopgap but remains susceptible to developing resistance when used as blood-stage therapy.

Atovaquone-Proguanil Remains a Potential Stopgap Therapy for Multidrug-Resistant Plasmodium falciparum in Areas along the Thai-Cambodian Border