Infectious Disease Book

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Malaria ChemoprophylaxisAka: Malaria Prophylaxis

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  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. Chemoprophylaxis: First Line
    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. Chemoprophylaxis: 2nd Line (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. Chemoprophylaxis: Third Line
    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. Chemoprophylaxis: Terminal prophylaxis
    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. Chemoprophylaxis: 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
    3. Lo Re (2003) Am Fam Physician 68(3):509

Antimalarial prophylaxis (C0199244)

ConceptsTherapeutic or Preventive Procedure (T061)
EnglishAntimalarial drug prophylaxis, Antimalarial prophylaxis, Malaria prophylaxis, Malarial prophylaxis
Spanishprescripción de un agente profiláctico antipalúdico, prescripcion de un agente profilactico antipaludico, profilaxis antipalúdica, profilaxis antipaludica, profilaxis contra la malaria, profilaxis farmacológica antipalúdica, profilaxis farmacologica antipaludica
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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