From the Guidelines
Doxycycline is a recommended medication for malaria prevention in areas where malaria is endemic, particularly in regions with mefloquine-resistant falciparum malaria, with a recommended dosage of 100 mg once daily. The medication should be started 1-2 days before entering the malaria-risk area, continued daily during the stay, and for 4 weeks after leaving the area 1. It is essential to note that doxycycline is contraindicated in children under 8 years old and pregnant women due to potential adverse effects on the fetus, including discoloration and dysplasia of the teeth and inhibition of bone growth 1. Common side effects of doxycycline include increased sun sensitivity, nausea, and diarrhea, which can be minimized by taking the medication with food and using sunscreen and protective clothing.
Some key points to consider when using doxycycline for malaria prevention include:
- Starting the medication 1-2 days before entering the malaria-risk area to ensure protective blood levels
- Continuing the medication daily during the stay and for 4 weeks after leaving the area
- Avoiding excessive sun exposure due to increased risk of photosensitization
- Using other preventive measures, such as insect repellent, bed nets, and wearing long sleeves and pants, especially during evening hours when mosquitoes are most active
- Being aware of malaria symptoms, including fever, chills, headache, and muscle aches, even when taking preventive medication.
It is crucial to weigh the benefits and risks of doxycycline use, considering the potential for adverse effects, particularly in vulnerable populations such as children and pregnant women 1.
From the FDA Drug Label
Doxycycline is indicated for the prophylaxis of malaria due to Plasmodium falciparum in short-term travelers (<4 months) to areas with chloroquine and/or pyrimethamine-sulfadoxine resistant strains Doxycycline offers substantial but not complete suppression of the asexual blood stages of Plasmodium strains. Patients taking doxycycline for malaria prophylaxis should be advised: that no present-day antimalarial agent, including doxycycline, guarantees protection against malaria. that doxycycline prophylaxis: should begin 1 to 2 days before travel to the malarious area, should be continued daily while in the malarious area and after leaving the malarious area, should be continued for 4 further weeks to avoid development of malaria after returning from an endemic area, should not exceed 4 months
Doxycycline is indicated for malaria prevention in short-term travelers to areas with chloroquine and/or pyrimethamine-sulfadoxine resistant strains.
- The prophylaxis should begin 1 to 2 days before travel to the malarious area.
- It should be continued daily while in the malarious area and after leaving the malarious area.
- The prophylaxis should be continued for 4 further weeks to avoid development of malaria after returning from an endemic area.
- It should not exceed 4 months. 2 2
From the Research
Efficacy of Doxycycline for Malaria Prevention
- Doxycycline is a partially efficacious causal prophylactic drug and a slow-acting blood schizontocidal agent highly effective for the prevention of malaria 3.
- It is especially useful as a prophylaxis in areas with chloroquine and multidrug-resistant Plasmodium falciparum malaria 3.
- Doxycycline is effective for malaria prophylaxis in travelers who are unable to take mefloquine 4.
Comparison with Other Antimalarial Agents
- Atovaquone-proguanil and doxycycline are the best tolerated regimens, and mefloquine is associated with adverse neuropsychiatric outcomes 5.
- Doxycycline users had fewer reported neuropsychiatric events than mefloquine users 5.
- Compared to mefloquine, atovaquone-proguanil users had fewer reports of any adverse effect, gastrointestinal adverse effects, and neuropsychiatric adverse events 5.