Drugs Information Center(DIC)

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

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 o

The treatment of choice for non-falciparum malaria is a 3-day course of oral chloroquine, to which only a limited proportion of P. vivax strains have gained resistance. Dormant parasites (hypnozoites) persist in the liver after treatment of P. vivax or P. ovale infection: the only currently effective drug for eradication of hypnozoites is primaquine. This must be avoided or given with caution under expert supervision in patients with glucose-6-phosphate dehydrogenase deficiency (G6PD), in whom it may cause severe haemolysis. Uncomplicated P. falciparum malaria can be treated orally with quinine, atovaquone plus proguanil (Malarone _) or co-artemether (Riamet_); quinine is highly effective but poorly tolerated in prolonged dosage and is always supplemented by additional treatment, usually with oral doxycycline.  ALL patients treated for P. falciparum malaria should be admitted to hospital for at least 24 h, since patients can deteriorate suddenly, especially early in the course of treat