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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/09/08 22:56:03」(JST)

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Atovaquone (alternative spelling: atavaquone) is a chemical compound that belongs to the class of naphthoquinones. Atovaquone is a hydroxy-1,4-naphthoquinone, an analog of ubiquinone, with antipneumocystic activity. It is manufactured in the US in the liquid form, or oral suspension, under the brand name Mepron.^[1]

Uses

Atovaquone is a medication used to treat or prevent:

For pneumocystis pneumonia (PCP),^[2]^[3] it is used in mild cases, although it is not approved for treatment of severe cases.
For toxoplasmosis,^[4] the medication has antiparasitic and therapeutic effects.
For malaria, it is one of the two components (along with proguanil) in the drug Malarone. Malarone has fewer side effects and is more expensive than mefloquine.^[5] Resistance has been observed.^[6]
For babesia, it is often used in conjunction with oral azithromycin.^[7]

Trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim) is generally considered first-line therapy for PCP or toxoplasmosis. However, atovaquone may be used in patients who cannot tolerate, or are allergic to, sulfonamide medications such as TMP-SMX. In addition, atovaquone has the advantage of not causing myelosuppression, which is an important issue in patients who have undergone bone marrow transplantation.

Malaria

Atovaquone, as a combination preparation with proguanil, has been commercially available from GlaxoSmithKline since 2000 as Malarone for the treatment and prevention of malaria.

References

^ GlaxoSmithKline (June 2015). "Mepron". Drugs.com. Retrieved June 22, 2016.
^ Hughes W, Leoung G, Kramer F, et al. (May 1993). "Comparison of atovaquone (566C80) with trimethoprim-sulfamethoxazole to treat Pneumocystis carinii pneumonia in patients with AIDS". N. Engl. J. Med. 328 (21): 1521–7. doi:10.1056/NEJM199305273282103. PMID 8479489.
^ Dohn MN, Weinberg WG, Torres RA, et al. (August 1994). "Oral atovaquone compared with intravenous pentamidine for Pneumocystis carinii pneumonia in patients with AIDS. Atovaquone Study Group". Ann. Intern. Med. 121 (3): 174–80. doi:10.7326/0003-4819-121-3-199408010-00003. PMID 7880228.
^ Djurković-Djaković O, Milenković V, Nikolić A, Bobić B, Grujić J (December 2002). "Efficacy of atovaquone combined with clindamycin against murine infection with a cystogenic (Me49) strain of Toxoplasma gondii". J. Antimicrob. Chemother. 50 (6): 981–7. doi:10.1093/jac/dkf251. PMID 12461021.
^ Malarone: New Malaria Medication With Fewer Side-effects
^ Färnert A, Lindberg J, Gil P, et al. (March 2003). "Evidence of Plasmodium falciparum malaria resistant to atovaquone and proguanil hydrochloride: case reports". BMJ. 326 (7390): 628–9. doi:10.1136/bmj.326.7390.628. PMC 151974. PMID 12649236.
^ Krause PJ, Lepore T, Sikand VK, et al. (November 2000). "Atovaquone and azithromycin for the treatment of babesiosis". N. Engl. J. Med. 343 (20): 1454–8. doi:10.1056/NEJM200011163432004. PMID 11078770.

External links

Media related to Atovaquone at Wikimedia Commons
Molecular Basis for Atovaquone Resistance in Pneumocystis jirovecii
Atovaquone (Meprone)
British National Formulary

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 抗マラリア剤：概要 antimalarial drugs an overview
2. HIV感染患者におけるニューモシスチス感染の予防 prophylaxis against pneumocystis infection in hiv infected patients
3. 旅行者におけるマラリア感染の予防 prevention of malaria infection in travelers
4. 非HIV感染患者におけるニューモシスチス肺炎の治療および予防 treatment and prevention of pneumocystis pneumonia in non hiv infected patients
5. 抗原虫治療 antiprotozoal therapies

English Journal

The therapeutic efficacy of two antibabesial strategies against Babesia gibsoni.

Lin EC, Chueh LL, Lin CN, Hsieh LE, Su BL.SourceInstitute of Veterinary Clinical Sciences, National Taiwan University, Taipei, Taiwan; National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan.
Veterinary parasitology.Vet Parasitol.2012 May 25;186(3-4):159-64. Epub 2011 Dec 6.
Various combination strategies for treating Babesia gibsoni have been described. However, relapses after administering some combinations of antibabesial drugs and the presence of drug-resistant B. gibsoni still pose significant challenges to veterinarians. To compare the efficacy of a combination of
PMID 22222008

Early treatment failure during treatment of plasmodium falciparum malaria with atovaquoneproguanil in the republic of ivory coast.

Wurtz N, Pascual A, Marin-Jauffre A, Bouchiba H, Benoit N, Desbordes M, Martelloni M, Pommier de Santi V, Richa G, Taudon N, Pradines B, Briolant S.AbstractABSTRACT: The increased spread of drug-resistant malaria highlights the need for alternative drugs for treatment and chemoprophylaxis. The combination of atovaquone and proguanil (Malarone(R)) has shown high efficacy against Plasmodium falciparum with only mild sideeffects. Treatment failures have been attributed to suboptimal dosages or to parasite resistance resulting from a point mutation in the cytochrome b gene. In this paper, a case of early treatment failure was reported in a patient treated with atovaquone-proguanil; this failure was not associated with a mutation in the parasite cytochrome b gene, with impaired drug bioavailability, or with re-infection.
Malaria journal.Malar J.2012 May 2;11(1):146. [Epub ahead of print]
ABSTRACT: The increased spread of drug-resistant malaria highlights the need for alternative drugs for treatment and chemoprophylaxis. The combination of atovaquone and proguanil (Malarone(R)) has shown high efficacy against Plasmodium falciparum with only mild sideeffects. Treatment failures have b
PMID 22551095

Japanese Journal

ニューモシスチス肺炎の治療 (特集ニューモシスチス肺炎 update)

青木孝弘,菊池嘉
日本胸部臨床 69(2), 131-136, 2010-02
NAID 40016986043

病原性酵母Candida albicansのin vitro生育に対するatovaquoneとリチウムの併用効果

皆川信子,上原麻理子,関志織,新田あゆみ,古河原健人
YAKUGAKU ZASSHI 130(2), 247-251, 2010
… Atovaquone, an analog of ubiquinone, binds tightly to the ubiquinol oxidation site (Qo site) of parasite cytochrome bc1 complex to inhibit electron transport at concentrations far lower than those at which the mammalian system is affected. … To treat Pneumocystis jirovecii and Plasmodium falciparum infections, atovaquone has been used worldwide whereas it is unapproved in Japan. …
NAID 130000171294

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★リンクテーブル★

リンク元	「アトバコン」「アトバクオン」

「アトバコン」

Atovaquone
Systematic (IUPAC) name
	trans-2-[4-(4-chlorophenyl)cyclohexyl]-3-hydroxy-1,4-naphthalenedione
Clinical data
Trade names	Mepron
AHFS/Drugs.com	Monograph
MedlinePlus	a693003
Routes of; administration	oral only
Legal status
Legal status	UK: POM (Prescription only); US: ℞-only;
Pharmacokinetic data
Biological half-life	2.2–3.2 days
Identifiers
CAS Number	95233-18-4
ATC code	P01AX06 (WHO)
PubChem	CID 74989
DrugBank	DB01117
ChemSpider	10482034
UNII	Y883P1Z2LT
KEGG	D00236
ChEBI	CHEBI:575568
ChEMBL	CHEMBL1450
Chemical data
Formula	C22H19ClO3
Molar mass	366.837 g/mol
	SMILES OC=2C(=O)c1ccccc1C(=O)C=2[C@@H]3CC[C@H](CC3)c4ccc(Cl)cc4 ;
	InChI InChI=1S/C22H19ClO3/c23-16-11-9-14(10-12-16)13-5-7-15(8-6-13)19-20(24)17-3-1-2-4-18(17)21(25)22(19)26/h1-4,9-13,15,26H,5-8H2/t13-,15- ; Key:KUCQYCKVKVOKAY-CTYIDZIISA-N ;
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　　[★]

英: atovaquone
商: サムチレール、マラロン配合
関: アトバクオン、その他の化学療法剤

「アトバクオン」

　　[★]

英: atovaquone
関: アトバコン

[1] GlaxoSmithKline (June 2015). "Mepron". Drugs.com. Retrieved June 22, 2016.

[pmid8479489-2] Hughes W, Leoung G, Kramer F, et al. (May 1993). "Comparison of atovaquone (566C80) with trimethoprim-sulfamethoxazole to treat Pneumocystis carinii pneumonia in patients with AIDS". N. Engl. J. Med. 328 (21): 1521–7. doi:10.1056/NEJM199305273282103. PMID 8479489.

[pmid7880228-3] Dohn MN, Weinberg WG, Torres RA, et al. (August 1994). "Oral atovaquone compared with intravenous pentamidine for Pneumocystis carinii pneumonia in patients with AIDS. Atovaquone Study Group". Ann. Intern. Med. 121 (3): 174–80. doi:10.7326/0003-4819-121-3-199408010-00003. PMID 7880228.

[pmid12461021-4] Djurković-Djaković O, Milenković V, Nikolić A, Bobić B, Grujić J (December 2002). "Efficacy of atovaquone combined with clindamycin against murine infection with a cystogenic (Me49) strain of Toxoplasma gondii". J. Antimicrob. Chemother. 50 (6): 981–7. doi:10.1093/jac/dkf251. PMID 12461021.

[5] Malarone: New Malaria Medication With Fewer Side-effects

[pmid12649236-6] Färnert A, Lindberg J, Gil P, et al. (March 2003). "Evidence of Plasmodium falciparum malaria resistant to atovaquone and proguanil hydrochloride: case reports". BMJ. 326 (7390): 628–9. doi:10.1136/bmj.326.7390.628. PMC 151974. PMID 12649236.

[7] Krause PJ, Lepore T, Sikand VK, et al. (November 2000). "Atovaquone and azithromycin for the treatment of babesiosis". N. Engl. J. Med. 343 (20): 1454–8. doi:10.1056/NEJM200011163432004. PMID 11078770.

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atovaquone