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Treatment of Malaria

Treatment of Malaria. Treatment. Many different antimalarials The decision of which to use is dependent on: Setting of treatment: remote region with fewer resources The resistances of the parasite Individual: age, pregnancy status Cost. Antimalarials. Chloroquine - Resistance

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Treatment of Malaria

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  1. Treatment of Malaria

  2. Treatment • Many different antimalarials • The decision of which to use is dependent on: • Setting of treatment: remote region with fewer resources • The resistances of the parasite • Individual: age, pregnancy status • Cost

  3. Antimalarials Chloroquine - Resistance - Less expensive - P. ovale, P. vivax, P. malariae

  4. Prophylaxis 1. Atovaquone + proguanil Daily Start 1-2 days before, stop 7 days after 1. Doxycycline Daily Start 2 days before, stop 4 weeks after 1. Mefloquine Weekly Start 2-3 weeks before, stop 4 weeks after Doxycycline: oesophagitis, photosensitivity, thrush Mefloquine: contraindicated in: neuropsychiatric disorders, epilepsy, cardiac conduction defects Prophylaxis not always effective

  5. Australian Therapeutic GuidelinesUncomplicated P. falciparum • Oral therapy 1. Artemether+ lumefantrine 2. Atovaquone+ proguanil 3. Quinine sulphate + Doxycyline Or Clindamycin(pregnancy & chidren)

  6. Severe malaria • Altered conscious state • Jaundice • Oliguria • Severe anaemia or hypoglycaemia • Parasite count >2% of RBCs • Acidotic

  7. Australian Therapeutic GuidelinesSevere P. falciparum • IV therapy 1. Artesunate 2.4mg/kg on admission Repeat at 12hr, 24hr, then once daily 2. Quinine dihydrochloride Loading dose, then maintenance dose

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