Template:Malaria antibiotics

For specific dosing see the CDC Recommendations or call the Malaria CDC Hotline(855) 856-4713

Uncomplicated Malaria

• Uncomplicated:
  • No evidence of organ dysfunction
  • Parasitemia <5%
  • Able to tolerate PO
• Hospitalize:
  • Severe clinical manifestations in non-immune host for P. falciparum or P. knowlesi
• Report to state health department
• For non-pregnant patients (3 day course)
  • Artemether + lumefantrine
  • Artesunate + amodiaquine
  • Artesunate + mefloquine
  • Dihydroartemisinin + piperaquine
  • Artesunate + sulfadoxine–pyrimethamine (SP)
• For pregnant (1st trimester)
  • Quinine + clindamycin x 7 days
• Additional considerations
  • Avoid artesunate + SP in HIV/AIDS patients taking co-trimoxazole
  • Avoid artesunate + amodiaquine in HIV/AIDS patients taking efavirenz or zidovudine
  • P. vivax and P. ovale have dormant hypnozoites in the liver which require treatment with primaquine phosphate for complete eradication

Severe Malaria

• Do not delay treatment in the unstable patient if strong suspicion for malaria as initial smear may be falsely negative
• Treatment (IV for ≥24 hours then 3 days PO course)
  • Artesunate (IV)
    • Clears malaria faster than quinine
    • Distributed only through CDC
  • Quinidine (IV) also appropriate choice; more available in US

Prophylaxis

• Doxycycline 100mg PO daily
• Doxycycline 2.2 mg/kg/day PO daily (max 100mg/day), >8 years old

Suppression

• Dapsone 100mg PO weekly

Quinine-based Regimens

Adult

• Quinine 648mg PO q8h x 7 days

Pediatric

• Quinine 30mg/kg/day PO q8h x 3-7 days (Max: 648mg/dose)