From the Guidelines
Antimalarial medications are indicated for the prevention and treatment of malaria, with artemisinin-based combination therapies (ACTs) like artemether-lumefantrine being first-line for uncomplicated P. falciparum malaria, as recommended by the most recent study 1.
Indications for Antimalarial Medications
- Prevention (chemoprophylaxis) for travelers to malaria-endemic regions
- Treatment of confirmed malaria
- Certain autoimmune conditions like lupus and rheumatoid arthritis
Treatment Options
- Artemisinin-based combination therapies (ACTs) like artemether-lumefantrine for uncomplicated P. falciparum malaria
- Intravenous artesunate for severe malaria
- Atovaquone-proguanil, doxycycline, and mefloquine for prevention and treatment in specific cases
Important Considerations
- Local resistance patterns
- Patient allergies
- Pregnancy status
- Potential drug interactions
Recent Guidelines
- The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) endorse the use of ACTs for uncomplicated malaria in all trimesters of pregnancy 1
- The French guidelines consider outpatient treatment for selected patients with uncomplicated P. falciparum malaria 1
From the FDA Drug Label
For the prophylaxis of malaria: For adults, the recommended dose is 100 mg daily. For children over 8 years of age, the recommended dose is 2 mg/kg given once daily up to the adult dose. Prophylaxis should begin 1 to 2 days before travel to the malarious area. Prophylaxis should be continued daily during travel in the malarious area and for 4 weeks after the traveler leaves the malarious area Quinine sulfate is an antimalarial indicated for treatment of uncomplicated Plasmodium falciparum malaria.
Antimalarial Indications:
- Doxycycline: for prophylaxis of malaria in adults and children over 8 years of age
- Quinine sulfate: for treatment of uncomplicated Plasmodium falciparum malaria Key Points:
- Doxycycline prophylaxis should begin 1 to 2 days before travel to the malarious area and continue daily during travel and for 4 weeks after leaving the area 2
- Quinine sulfate is not approved for prevention of malaria or treatment of severe or complicated P. falciparum malaria 3
From the Research
Indications for Antimalarial Use
Antimalarial medications are indicated for the prevention and treatment of malaria, a disease caused by Plasmodium parasites. The choice of antimalarial agent depends on various factors, including the destination of travel, the presence of drug resistance, and the individual's medical history.
Prevention of Malaria
- Antimalarial prophylaxis is recommended for travelers to areas with high transmission of Plasmodium falciparum, particularly in sub-Saharan Africa and Southeast Asia 4, 5.
- Atovaquone-proguanil, doxycycline, and mefloquine are commonly used antimalarial agents for prophylaxis, with varying efficacy and safety profiles 5, 6.
- The choice of antimalarial agent for prophylaxis depends on the individual's risk factors, medical history, and personal preferences.
Treatment of Uncomplicated Malaria
- Antimalarial agents, such as atovaquone-proguanil, artemether-lumefantrine, and mefloquine, are effective for the treatment of uncomplicated Plasmodium falciparum malaria 7, 8.
- The choice of antimalarial agent for treatment depends on the severity of the disease, the presence of drug resistance, and the individual's medical history.
- Combination therapy, such as artesunate-atovaquone-proguanil, may be more effective than monotherapy in reducing treatment failure rates 7.
Special Considerations
- Pregnant women and children may require special consideration when selecting an antimalarial agent, due to potential safety concerns and limited data on efficacy and safety in these populations.
- Individuals with a history of psychiatric disorders or neurological conditions may need to avoid certain antimalarial agents, such as mefloquine, due to potential adverse effects 6.