Eyal Meltzer1,2, Eli Schwartz3,4. 1. Center for Geographic Medicine and Department of Medicine C, Sheba Medical Center, 52621, Tel Hashomer, Israel. emeltzer@post.tau.ac.il. 2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. emeltzer@post.tau.ac.il. 3. Center for Geographic Medicine and Department of Medicine C, Sheba Medical Center, 52621, Tel Hashomer, Israel. elischwa@post.tau.ac.il. 4. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. elischwa@post.tau.ac.il.
Abstract
PURPOSE OF REVIEW: To review the current status of 8-aminoquinolines in the prophylaxis of malaria among travelers, in light of the recent approval of tafenoquine. RECENT FINDINGS: Primaquine continues to provide excellent primary prophylaxis against all Plasmodium species. Tafenoquine provides similarly good prophylaxis, with the benefit of weekly dosing. Both agents require glucose-6-phosphate dehydrogenase activity testing before use and are contraindicated in pregnancy. Pharmacodynamic variability relating to CYP2D6 may underlie some cases of primaquine failure; the effects of CYP2D6 on tafenoquine efficacy require further study. Tafenoquine and primaquine are the only current drugs that provide complete malaria prophylaxis, and should be considered the agents of choice in areas where both P. vivax and falciparum are frequent. Monthly tafenoquine is promising and should be further studied in travelers.
PURPOSE OF REVIEW: To review the current status of 8-aminoquinolines in the prophylaxis of malaria among travelers, in light of the recent approval of tafenoquine. RECENT FINDINGS:Primaquine continues to provide excellent primary prophylaxis against all Plasmodium species. Tafenoquine provides similarly good prophylaxis, with the benefit of weekly dosing. Both agents require glucose-6-phosphate dehydrogenase activity testing before use and are contraindicated in pregnancy. Pharmacodynamic variability relating to CYP2D6 may underlie some cases of primaquine failure; the effects of CYP2D6 on tafenoquine efficacy require further study. Tafenoquine and primaquine are the only current drugs that provide complete malaria prophylaxis, and should be considered the agents of choice in areas where both P. vivax and falciparum are frequent. Monthly tafenoquine is promising and should be further studied in travelers.
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