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

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

doi:10.1086/515071

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

Walter R. J. Taylor

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

Correspondence: Dr. W. R. J. Taylor, 26, Pitchford Road, Shrewsbury, Shropshire, SY1 3HS, United Kingdom (Bobbo1@compuserve.com).

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Walter R. J. Taylor

Thomas L. Richie

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Thomas L. Richie

David J. Fryauff

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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David J. Fryauff

Helena Picarima

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Helena Picarima

Colin Ohrt

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Colin Ohrt

Douglas Tang

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Douglas Tang

David Braitman

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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David Braitman

Gerald S. Murphy

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Gerald S. Murphy

Hendra Widjaja

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Hendra Widjaja

Emiliana Tjitra

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Emiliana Tjitra ... Show more

Asep Ganjar

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Asep Ganjar

Trevor R. Jones

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Trevor R. Jones

Hasan Basri

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Hasan Basri

Josh Berman

From the

U.S. Naval Medical Research Unit Number 2

Jakarta, Indonesia

; the

Department of Tropical Medicine, Tulane University School of Public Health

New Orleans, Louisiana

, the

Division of Experimental Therapeutics and the Division of Biometrics, Walter Reed Army Institute of Research

Washington, D.C.

, and the

U.S. Army Medical Materiel Development Activity

Fort Dietrick, Maryland, USA

; and the

Centre for Health Research and Development, National Institutes of Health, and the District Military Health Services

Jayapura, Irian Jaya, Indonesia

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Josh Berman

Clinical Infectious Diseases, Volume 28, Issue 1, 1 January 1999, Pages 74–81, https://doi.org/10.1086/515071

Published:

01 January 1999

Article history

Received:

06 May 1998

Revision Received:

24 August 1998

Abstract

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

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

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