From the FDA Drug Label
The safety and effectiveness of mefloquine to treat malaria in pediatric patients below the age of 6 months have not been established Experience with mefloquine in pediatric patients weighing less than 20 kg is limited. The recommended anti-malarial regimen for a 7-month-old infant is not established for mefloquine, as the safety and effectiveness of the drug have not been established in pediatric patients below the age of 6 months 1.
From the Research
For a 7-month-old infant requiring antimalarial treatment, artemether-lumefantrine (Coartem) is recommended at a dose of 1-2 tablets twice daily for 3 days, adjusted for the infant's weight, as it has been shown to be effective and safe in children younger than 5 years with uncomplicated Plasmodium falciparum malaria in Africa 2.
Key Considerations
- The most recent and highest quality study, published in 2022, compared the efficacy of quinine plus clindamycin with artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in children, and found that artemether-lumefantrine was significantly more effective 3.
- Another study published in 2016, found that artesunate-mefloquine is effective and safe for children younger than 5 years with uncomplicated P falciparum malaria in Africa, but artemether-lumefantrine is still the most widely used and recommended treatment 2.
- It is crucial to accurately weigh the infant to ensure proper dosing, as the medications work by interfering with the parasite's ability to reproduce or by disrupting its metabolic processes.
- Side effects may include vomiting or diarrhea, so monitoring the infant closely is important.
- Always consult with a pediatrician or infectious disease specialist before administering antimalarials to infants, as dosing is weight-dependent and some medications are contraindicated in young children.
Administration and Monitoring
- Proper administration with food and ensuring the infant keeps the medication down are essential for effective treatment.
- The infant should be monitored closely for signs of toxicity or adverse reactions, such as vomiting, diarrhea, or neurological symptoms.
- The treatment should be completed for the full 3-day course, even if the infant appears to be recovering, to ensure that the parasite is fully cleared from the body.