Treatment Guidelines for Malaria Contd...
Treatment regimens for uncomplicated malaria in adults _ Oral quinine sulphate 600 mg/8 h for 5e7 days plus doxycycline 200 mg daily (or clindamycin 450 mg/8 h for pregnant women) for 7 days _ Atovaquoneeproguanil (Malarone_): 4 ‘standard’ tablets daily for 3 days or _ Co-artem ((artemetherelumefantrine_): if weight > 35 kg, 4 tablets then 4 tablets at 8, 24, 36, 48 and 60 h Child Initial dose 10 mg/kg/base then 5 mg/kg base 6e8 h later and on days 2 and 3 However, both of these newer regimens need to be taken for only 3 days. In contrast, quinine needs to be taken for 5e7 days and is often associated with ‘‘cinchonism’’ (nausea, deafness and ringing in the ears), which often results in poor adherence. Although international recommendations suggest that quinine should be taken for 7 days in endemic areas, 2 UK experience suggests that 5 days treatment is adequate for the vast majority of cases. Quinine should be combined with a second drug (doxycycline for adults or clindam...