Infectious Disease Book

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Malaria Chemoprophylaxis

Aka: Malaria Chemoprophylaxis, Malaria Prophylaxis
  1. See Also
    1. Malaria
    2. Prevention of Vector-borne Infection
  2. General
    1. Always check CDC for resistance before prescribing
      1. CDC Travelers Health for regional recommendations
        1. http://www.cdc.gov/travel
    2. Chemoprophylaxis is for prevention only
      1. Dosing below does not apply to Malaria treatment
    3. Chemoprophylaxis Schedule
      1. Agents are started 1-2 weeks before travel
      2. Agents are continued for 4 weeks after travel
  3. Prevention: First-Line Chemoprophylaxis
    1. Indications (Areas of no Chloroquine Resistance)
      1. Mexico
      2. Caribbean
      3. Central America
      4. Argentina
      5. Some areas in Middle East
      6. Some areas of China
    2. Chloroquine (Aralen)
      1. Adult: 500 mg (300 mg base) PO weekly
      2. Child: 8.3 mg/kg (5 mg/kg of base) PO weekly
  4. Prevention: Second-line chemoprophylaxis (if No Mefloquine resistance)
    1. Indications
      1. Chloroquine resistance
      2. Safe in pregnancy
    2. Contraindications (relative)
      1. Seizure disorder
      2. Cardiac conduction abnormality
      3. Psychosis
    3. Mefloquine (Lariam)
      1. Adult: 250 mg (228 mg base) PO weekly
      2. Child: See Mefloquine for pediatric dosing
  5. Prevention: Third-Line Chemoprophylaxis
    1. Indications
      1. Short term travel to Chloroquine resistance areas
      2. Mefloquine resistance areas
        1. Thailand - Cambodia border
        2. Thailand - Myanmar (Burma) border
    2. Contraindications
      1. Lactating women
      2. Children under age 8 years
    3. Doxycycline (Vibramycin)
      1. Adult Dosing: 100 mg PO qd
      2. Pediatric Dosing (may use if older than age 8)
        1. Dose: 2 mg/kg/day up to 100 mg qd
  6. Prevention: Terminal Chemoprophylaxis
    1. Indications (on leaving endemic area)
      1. Prolonged exposure to P. vivax or P. ovale
      2. Taken for 14 days on leaving endemic area
    2. Contraindications
      1. Pregnancy
      2. G6PD Deficiency
    3. Adult dose
      1. Primaquine 26.3 mg PO qd for 14 days
  7. Prevention: Chemoprophylaxis with other agents (adult dosing)
    1. Atovaquone/Proguanil (Malarone) 250/100 mg PO qd
    2. Azithromycin (Zithromax) 250 mg PO qd
    3. Tafenoquine (Etaquine) 250 mg PO weekly
    4. Pyrimethamine with sulfadoxine (Fansidar)
  8. References
    1. Gilbert (2001) Sanford Guide, p. 88
    2. Kain (2001) Clin Infect Dis 33:226-34
    3. Lo Re (2003) Am Fam Physician 68(3):509-16

Antimalarial prophylaxis (C0199244)

Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 81364009, 420848008, 268592001
English Prescription of drug, prophylactic, anti-malarial, Prescription of prophylactic anti-malarial, Anti-malarial prophylaxis, Antimalarial drug prophylaxis, Malarial prophylaxis, Prescription of prophylactic anti-malarial (procedure), Antimalarial prophylaxis (procedure), Antimalarial prophylaxis, Malaria prophylaxis, malaria prophylaxis
Italian Profilassi della malaria, Profilassi malarica
Spanish profilaxis antipalúdica, profilaxis contra la malaria, profilaxis antipalúdica (procedimiento), profilaxis farmacológica antipalúdica, prescripción de un agente profiláctico antipalúdico (procedimiento), prescripción de un agente profiláctico antipalúdico, Antimalarial drug prophylaxis, Malaria prophylaxis, Profilaxis de paludismo
Dutch malaria profylaxe, malariaprofylaxe
French Prophylaxie du paludisme, Prophylaxie antipaludéenne
Japanese マラリア予防, マラリアヨボウ
Czech Profylaxe malárie, Antimalarická profylaxe
Hungarian Malária profilaxis
Portuguese Profilaxia da malária
German Malariaprophylaxe
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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