Marlene Bloechliger1, Patricia Schlagenhauf2, Stephen Toovey3, Gabriel Schnetzler4, Iain Tatt5, Danitza Tomianovic6, Susan S Jick7, Christoph R Meier8. 1. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy & Epidemiology, Department of Pharmaceutical Sciences, University Basel, Switzerland. Electronic address: Marlene.Bloechliger@usb.ch. 2. University of Zurich Centre for Travel Medicine, Institute for Social and Preventive Medicine, Zurich, Switzerland. Electronic address: pat@ifspm.uzh.ch. 3. Division of Infection and Immunity, Royal Free and University College Medical School, Academic Centre for Travel Medicine and Vaccines, London, UK. Electronic address: malaria@sunrise.ch. 4. F.Hoffmann-La Roche Ltd., Basel, Switzerland. Electronic address: gabriel.schnetzler@roche.com. 5. F.Hoffmann-La Roche Ltd., Basel, Switzerland. Electronic address: iain.tatt@roche.com. 6. F.Hoffmann-La Roche Ltd., Basel, Switzerland. Electronic address: danitza.tomianovic@roche.com. 7. Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, United States. Electronic address: sjick@bu.edu. 8. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy & Epidemiology, Department of Pharmaceutical Sciences, University Basel, Switzerland; Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, United States; Hospital Pharmacy, University Hospital Basel, Switzerland. Electronic address: Christoph.Meier@usb.ch.
Abstract
BACKGROUND: Mefloquine belongs to the priority chemoprophylaxis drugs for travelers to malaria endemic regions. We aimed to assess the prescribing patterns for mefloquine and other antimalarials. METHODS: We conducted a descriptive drug utilization study using the U.K. Clinical Practice Research Datalink (CPRD). We assessed characteristics of individuals with a first-time antimalarial prescription for mefloquine, atovaquone/proguanil, chloroquine and/or proguanil, or doxycycline between 2001 and 2012. RESULTS: Of 165,218 individuals with a first-time antimalarial prescription, 108,344 (65.6%), 25,294 (15.3%), 23,195 (14.0%), and 8385 (5.1%) were prescribed atovaquone/proguanil, mefloquine, doxycycline, and chloroquine and/or proguanil, respectively. Among mefloquine users, 7.5% had a history of a neuropsychiatric disorder (versus 12.6%-13.7% among other antimalarial users) and 0.04% had a history of severe liver disease (versus 0.04%-0.1% among other antimalarial users). A total of 19.4% mefloquine users were children younger than 12 years (versus 0.4%-15.8% among other antimalarials), and 1.3% pregnant or postpartum women (versus 0.4%-1.4% among users of other antimalarials). CONCLUSIONS: The most frequently prescribed antimalarial chemoprophylaxis was atovaquone/proguanil. Mefloquine was occasionally prescribed for patients with comorbidities listed as contraindications, but most practitioners observed contraindications. Mefloquine was often prescribed for children and pregnant women.
BACKGROUND:Mefloquine belongs to the priority chemoprophylaxis drugs for travelers to malaria endemic regions. We aimed to assess the prescribing patterns for mefloquine and other antimalarials. METHODS: We conducted a descriptive drug utilization study using the U.K. Clinical Practice Research Datalink (CPRD). We assessed characteristics of individuals with a first-time antimalarial prescription for mefloquine, atovaquone/proguanil, chloroquine and/or proguanil, or doxycycline between 2001 and 2012. RESULTS: Of 165,218 individuals with a first-time antimalarial prescription, 108,344 (65.6%), 25,294 (15.3%), 23,195 (14.0%), and 8385 (5.1%) were prescribed atovaquone/proguanil, mefloquine, doxycycline, and chloroquine and/or proguanil, respectively. Among mefloquine users, 7.5% had a history of a neuropsychiatric disorder (versus 12.6%-13.7% among other antimalarial users) and 0.04% had a history of severe liver disease (versus 0.04%-0.1% among other antimalarial users). A total of 19.4% mefloquine users were children younger than 12 years (versus 0.4%-15.8% among other antimalarials), and 1.3% pregnant or postpartum women (versus 0.4%-1.4% among users of other antimalarials). CONCLUSIONS: The most frequently prescribed antimalarial chemoprophylaxis was atovaquone/proguanil. Mefloquine was occasionally prescribed for patients with comorbidities listed as contraindications, but most practitioners observed contraindications. Mefloquine was often prescribed for children and pregnant women.
Authors: Trevor N Johnson; Yumi Cleary; Neil Parrott; Bruno Reigner; James R Smith; Stephen Toovey Journal: Br J Clin Pharmacol Date: 2018-11-05 Impact factor: 4.335
Authors: Annina K Käser; Paul M Arguin; Peter L Chiodini; Valerie Smith; Jean Delmont; Beatriz C Jiménez; Anna Färnert; Mikio Kimura; Michael Ramharter; Martin P Grobusch; Patricia Schlagenhauf Journal: Travel Med Infect Dis Date: 2015-07-09 Impact factor: 6.211