Version May 2024
| Type of infection | Trimester | Drug and dose |
| Chloroquine-resistant infection | First trimester | Artemether-lumefantrine:* 1 tablet = 20 mg artemether and 120 mg lumefantrine. A three-day treatment schedule with a total of six oral doses is recommended based on weight (25 to 34 kg: 3 tablets per dose; ≥35 kg: 4 tablets per dose). The patient should receive the initial dose, followed by the second dose 8 hours later, then 1 dose orally twice daily for the following two days. Take after a full meal or whole milk. or Other artemisinin combination therapy: – One of the following:
or Quinine sulfate:Δ 542 mg base (= 650 mg salt) orally 3 times daily for three or seven days. |
| Second or third trimester | Artemisinin combination therapy – One of the following (dosing above):
or Quinine sulfate (dosing above). | |
| Chloroquine-sensitive infection | First trimester | Chloroquine:
or Hydroxychloroquine:
or Artemether-lumefantrine:* 1 tablet = 20 mg artemether and 120 mg lumefantrine. A three-day treatment schedule with a total of six oral doses is recommended based on weight (25 to 34 kg: 3 tablets per dose; ≥35 kg: 4 tablets per dose). The patient should receive the initial dose, followed by the second dose 8 hours later, then 1 dose orally twice daily for the following two days. Take after a full meal or whole milk. or Other artemisinin combination therapy – One of the following (dosing above):
|
| Second or third trimester | Chloroquine or hydroxychloroquine: Dosing as above. or Artemisinin combination therapy – One of the following (dosing as above):
| |
| Anti-relapse therapy (for infections with P. vivax of P. ovale) | Refer to separate table |
G6PD: glucose-6-phosphate-dehydrogenase.
* Among the ACTs, artemether-lumefantrine has been associated with the most favorable safety data in pregnancy. Refer to related UpToDate content for further discussion.
¶ Piperaquine component prolongs the QT interval by approximately the same amount as chloroquine but by less than quinine; avoid use in patients with congenital QT prolongation or who are on medications that prolong the QT interval. Dihydroartemisinin-piperaquine may be taken with food but should not be taken with a high-fat meal.
Δ For infections acquired in Southeast Asia, quinine treatment should continue for seven days. For infections acquired in Africa and South America, quinine treatment should continue for three days. In the United States, quinine is encapsulated in a 324 mg (sulfate salt) dose; therefore, for adult dosing, two capsules are sufficient.
◊ The dosing for chloroquine summarized in the table is based on the recommendations of the United States Centers for Disease Control and Prevention. The dosing for chloroquine recommended by the World Health Organization consists of the following: Total dose: 25 mg base/kg, administered as 10 mg base/kg orally on day 1 followed by 10 mg/kg orally on day 2, and 5 mg/kg base on day 3.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
