Sandbox m ex
Anti-malarial Agents
Anti-malarial Agent | Indication | Dosing |
Chloroquine phosphate | P. falciparum from chloroquine-sensitive areas P. vivax from chloroquine-sensitive areas All P. ovale All P. malariae |
1g oral load, followed by 500 mg orally at 6, 24, and 48 h |
Hydroxychloroquine | Same as chloroquine (second line agent) | 800 mg oral load, followed by 400 mg orally at 6, 24, and 48 h |
Atovaquone-Proguanil | P. falciparum from chloroquine-resistant areas | 250 mg atovaquone/100 mg proguanil (1 tab) orally 4 times daily for 3 days |
Primaquine phosphate | Cure of P. vivax and P. ovale (to eliminate hypnozoites) | 30 mg orally once daily for 14 days |
Clindamycin* | P. falciparum or P. vivax from chloroquine-resistant areas | 20 mg/kg/day orally for 3 days or 10 mg/kg IV load, followed by 5 mg/kg IV every 8 hours |
Doxycycline* | P. falciparum or P. vivax from chloroquine-resistant areas | 100 mg orally twice daily for 7 days or 100 mg IV every 12 hours for 7 days (can switch from IV to PO) |
Tertacycline* | P. falciparum or P. vivax from chloroquine-resistant areas | 250 mg orally 4 times daily for 7 days or 250 mg IV 4 times daily for 7 days (can switch from IV to PO) |
Mefloquine | P. falciparum or P. vivax from chloroquine-resistant areas except Thailand-Burmese and Thailand-Cambodian border regions | 750 mg oral load, followed by 500 mg orally 6-12 hours after initial dose |
Quinine sulfate | P. falciparum or P. vivax from chloroquine-resistant areas | 650 mg orally 3 times daily for 3 days or 7 days if acquired from Southeast Asia |
Quinidine gluconate | Severe malaria (all species Unable to tolerate oral agents Parasitemia>10% |
10 mg/kg IV load over 1-2 hours, then 0.02 mg/kg/min continuous infusion for at least 24 hours |
Artemether-lumefantrine | All P. falciparum (outside USA) | 1.5 mg/kg - 9 mg/kg orally twice daily for 3 days |
Dihydroartemisinin–piperaquine | All P. falciparum (outside USA) | 2·5 mg/kg – 20 mg/kg orally once daily for 3 days |
Artesunate | All P. falciparum (outside USA) First line IV agent for severe malaria (outside USA) |
In severe malaria: 2.4 mg/kg IV or IM load, followed by 2.4 mg/kg at 12 h and 24 h; continue injection once daily if necessary In uncomplicated malaria: Monotherapy not recommended, 4mg/kg orally once daily for 3 days combined with a single oral dose of sulfadoxine–pyrimethamine 25/1.25 mg/kg or mefloquine 8 mg/kg orally daily for 3 days |
*Used in combination with quinine or quinidine