According to the results of a study published in the journal Cancer, atovaquone (Mepron®, Malarone®) offers effective protection against Pneumocystis carinii pneumonia in children with leukemia.

Pneumocystis carinii pneumonia is a common infection in immunosuppressed patients, including children with leukemia. Trimethoprim-sulfamethoxazole (Bactrim®, Septra®) is the usual drug of choice for prevention of Pneumocystis carinii pneumonia in immunosuppressed children and adults. However, intolerance or allergies to trimethoprim-sulfamethoxazole are common, and alternatives approaches to pneumonia prevention are needed for patients who cannot tolerate trimethoprim-sulfamethoxazole.

Atovaquone is an anti-malarial drug which is active for the treatment and prevention of Pneumocystis cariniipneumonia in immunosuppressed adults; it has been used extensively in patients with HIV infection. Atovaquone is also active for the treatment of patients with Pneumocystis carinii pneumonia who fail to respond to trimethoprim-sulfamethoxazole.[[1]]( "_ednref1")

To evaluate response to atovaquone in pediatric leukemia patients, researchers evaluated 86 children who could not tolerate trimethoprim-sulfamethoxazole.[[2]]( "_ednref2") The children received daily atovaquone for the prevention of Pneumocystis carinii pneumonia.

  • Atovaquone appeared to be well tolerated.
  • None of the patients developed Pneumocystis carinii pneumonia.

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The researchers conclude that atovaquone appears to be an effective alternative agent for prevention of Pneumocystis carinii pneumonia in children with leukemia who are intolerant of trimethoprim-sulfamethoxazole.


[[1]]( "_edn1") Amego RA, Nagar S, Maloba B, et al. A meta-analysis of salvage therapy for Pneumocystis cariniipneumonia. Archives of Internal Medicine. 2001;161:1529-1533.

[[2]]( "_edn2") Madden RM, Pui C-H, Hughes WT, Flynn PM, Leung W. Prophylaxis of pneumocystis carinii pneumonia with atovaquone in children with leukemia. Cancer. 2007;109:1654-8.

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