Malarone vs. Bactrim for Malaria and Pneumonia: Important Differences and Potential Risks.

Key takeaways

Malarone (atovaquone/proguanil) and Bactrim (sulfamethoxazole/trimethoprim) are both prescription medications, but they are used for different purposes. Malarone is an antimalarial medication used to prevent and treat malaria, while Bactrim is an antibiotic used to treat various bacterial infections, such as urinary tract infections (UTIs), ear infections, and lung infections. Malarone is taken once daily, whereas Bactrim is typically taken twice daily. Malarone is not recommended for people with severe kidney or liver problems, and it is not advised for pregnant or breastfeeding women. On the other hand, Bactrim is not suitable for those with a sulfa allergy, severe liver or kidney problems, or during pregnancy. Bactrim can also make your skin more sensitive to the sun, which is not a common issue with Malarone. Both medications have generic forms available, making them more affordable options.

Malarone

(atovaquone / proguanil)

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Sulfamethoxazole/trimethoprim

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Summary for Malarone

Prescription only

Malarone (atovaquone / proguanil) is a CDC-recommended medication to help prevent and treat malaria. This combination medication is taken by mouth once per day. It doesn't have many side effects and can be used in children and adults.

Indications for Malarone

Prevention and treatment of malaria caused by Plasmodium falciparum species

Pros and Cons for Malarone

Pros

Works well for preventing and treating malaria
Can use for traveling to areas known to have resistance to chloroquine, another antimalarial medication
Good choice for shorter trips because you only have to take it for 1 more week after leaving from the malaria area, rather than for 4 more weeks with other malaria medications (e.g., mefloquine, chloroquine)
Has relatively few side effects

Cons

Not the best choice for people with severe kidney or liver problems
Not recommended for pregnant or breastfeeding females
Taken once per day (compared to other antimalarial medications that are taken once per week)

Common Side Effects for Malarone

Stomach pain
Nausea
Vomiting
Diarrhea
Low appetite
Headache
Weakness
Dizziness

Warnings for Malarone

Worsening infection
Liver damage

Summary for Bactrim

Prescription only

Sulfamethoxazole/trimethoprim (sometimes known as SMZ/TMP) is a combination medication containing an antifolate and sulfa antibiotic. It's used to treat different types of infections, such as urinary tract infections (UTIs), ear infections, and lung infections. This antibiotic has two different brand names, Bactrim and Septra, and it's also available as a lower-cost generic. It's a tablet that's taken by mouth, typically twice daily for most types of infections. This antibiotic also comes as a suspension under the brand name Sulfatrim for people who can't swallow tablets and as an injection for people in the hospital. Common side effects include nausea, diarrhea, and rash.

Indications for Bactrim

Urinary tract infection (UTI)
Lower respiratory tract infection (e.g., Pneumocystis pneumonia, infections related to bronchitis)
Diarrhea caused by Shigella (shigellosis)
Travelers' diarrhea - tablet or liquid only
Ear infections - tablet or liquid only

Pros and Cons for Bactrim

Pros

Treats many types of bacterial infections
Can be given to children as young as 2 months old to treat certain infections
Available as a lower-cost generic

Cons

Can upset your stomach and make your skin more sensitive to the sun
Not the best choice for people with liver or kidney problems
Not recommended if you're pregnant
Can't take if you have a sulfa allergy

Common Side Effects for Bactrim

Nausea
Vomiting
Diarrhea
Loss of appetite
Rash
Hives
Skin sensitivity to sun or light

Warnings for Bactrim

Not for use during pregnancy
Severe allergic reactions and skin reactions
Low platelet counts and risk for bleeding
Diarrhea from Clostridioides difficile infection
Low sodium levels and high potassium levels
Blood cell-related problems
Problems with processing phenylalanine - for people with phenylketonuria (PKU) only