{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T20:03:05Z","timestamp":1789502585381,"version":"build-2803163510"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    A 58-year-old man with a past medical history significant for cerebrovascular accident with residual quadriplegia and feeding-tube dependence, latent tuberculosis infection, and prior treated malaria who developed relapsed\n                    <jats:italic>Plasmodium vivax<\/jats:italic>\n                    infection while receiving rifampin-based therapy for latent tuberculosis is discussed. Although standard-dose atovaquone\u2013proguanil remained a reasonable treatment option, an increased-dose regimen was selected given concern that rifampin-induced hepatic enzyme induction would lower atovaquone\u2013proguanil plasma concentrations. The patient was treated with atovaquone\u2013proguanil 2,000 mg\/800 mg daily (double the standard dose of both components) for 6 days (double the standard 3-day duration) from hospital day 4 to hospital day 9. Primaquine 30 mg daily (standard dose) was started on hospital day 5 and continued for 14 days. This regimen achieved complete resolution of parasitemia and sustained clinical cure at follow-up.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.26-0413","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:08:21Z","timestamp":1789499301000},"source":"Crossref","is-referenced-by-count":0,"title":["Treatment of Relapsed Plasmodium vivax with High-Dose Atovaquone\u2013Proguanil in the Setting of Long-Term Rifampin Use"],"prefix":"10.4269","author":[{"given":"Basil A.","family":"McIntosh","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreena P.","family":"Advani","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Grady Health System, Atlanta, Georgia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea C.","family":"Morales-Lara","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli P.","family":"Wilber","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA;"},{"name":"Department of Infectious Diseases, Grady Health System, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Am J Trop Med Hyg","first-page":"15","article-title":"Global epidemiology of Plasmodium vivax.","volume":"95","author":"Howes","year":"2016"},{"key":"b2","article-title":"World Malaria Report 2025.","year":"2025"},{"issue":"10195","key":"b3","series-title":"Lancet","first-page":"332","article-title":"Mapping the global endemicity and clinical burden of Plasmodium vivax, 2000\u201317: A spatial and temporal modelling study","volume":"394","author":"Battle","year":"2019"},{"issue":"1","key":"b4","series-title":"PLoS Negl Trop Dis","first-page":"e0007140","article-title":"Growing evidence of Plasmodium vivax across malaria-endemic Africa","volume":"13","author":"Twohig","year":"2019"},{"issue":"4","key":"b5","series-title":"JAMA Netw Open","first-page":"e181449","article-title":"Association of impaired cytochrome P450 2D6 activity genotype and phenotype with therapeutic efficacy of primaquine treatment for latent Plasmodium vivax malaria","volume":"1","author":"Baird","year":"2018"},{"key":"b6","article-title":"Relapsing Malaria. StatPearls [Internet]","author":"Menkin-Smith","year":"2026"},{"issue":"3","key":"b7","series-title":"Am J Trop Med Hyg","first-page":"1094","article-title":"Estimating the proportion of Plasmodium vivax recurrences caused by relapse: A systematic review and meta-analysis","volume":"103","author":"Commons","year":"2020"},{"issue":"6","key":"b8","series-title":"AIDS","first-page":"961","article-title":"Lower artemether, dihydroartemisinin and lumefantrine concentrations during rifampicin-based tuberculosis treatment","volume":"27","author":"Lamorde","year":"2013"},{"key":"b9","article-title":"MALARONE (Atovaquone and Proguanil Hydrochloride) Tablets: Prescribing Information.","year":"2019"},{"issue":"1","key":"b10","series-title":"Clin Infect Dis","first-page":"137","article-title":"Drug-free holidays: Compliance, tolerability, and acceptability of a 3-day atovaquone\/proguanil schedule for pretravel malaria chemoprophylaxis in Australian travelers","volume":"69","author":"Lau","year":"2019"},{"issue":"5","key":"b11","series-title":"J Antimicrob Chemother","first-page":"872","article-title":"Pharmacokinetics and pharmacodynamics of drug interactions involving rifampicin, rifabutin and antimalarial drugs","volume":"62","author":"Sousa","year":"2008"},{"key":"b12","series-title":"CDC Yellow Book\u2122: Health Information for International Travel","article-title":"Malaria","author":"Ridpath","year":"2025"},{"issue":"10","key":"b13","series-title":"Antimicrob Agents Chemother","first-page":"e00538-19","article-title":"CYP2D6 polymorphisms and the safety and gametocytocidal activity of single-dose primaquine for Plasmodium falciparum.","volume":"63","author":"Pett","year":"2019"},{"issue":"3","key":"b14","series-title":"N Engl J Med","first-page":"215","article-title":"Single-dose tafenoquine to prevent relapse of Plasmodium vivax malaria","volume":"380","author":"Lacerda","year":"2019"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.26-0413\/article-10.4269-ajtmh.26-0413.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/aop\/article-10.4269-ajtmh.26-0413\/article-10.4269-ajtmh.26-0413.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:08:22Z","timestamp":1789499302000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.26-0413\/article-10.4269-ajtmh.26-0413.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":14,"URL":"https:\/\/doi.org\/10.4269\/ajtmh.26-0413","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]}}}