5-Minute Clinical Consult : Malaria

Malaria

General Prevention

Mosquito avoidance measures: Insect repellent, clothing that covers most of the body, mosquito nets treated with permethrin, air conditioning, and avoiding outdoor activity dusk to dawn (1)[A]
Malarial chemoprophylaxis when in endemic area
Mefloquine: Begin at least 2 weeks before arrival and continue for 4 weeks after leaving area. Adults, 250 mg (1 tablet) weekly; children ≤9 kg, 5 mg/kg; children >9–19 kg, 1/4 tablet weekly; children >19–30 kg, 1/2 tablet weekly; children >30–45 kg, 3/4 tablet weekly; children >45 kg as adult:
- Caution: Mefloquine-resistant areas
Atovaquone/proguanil: Begin 1–2 days before arrival and continue for 1 week after leaving area. Adults, 1 adult tablet daily; children 5–8 kg, 1/2 pediatric tablet daily; children >8–10 kg, 3/4 pediatric tablet daily; children >10–20 kg, 1 pediatric tablet daily; children >20–30 kg, 2 pediatric tablets daily; children >30–40 kg, 3 pediatric tablets daily; children >40 kg, 1 adult tablet daily
Doxycycline: Begin 1–2 days before arrival and continue for 4 weeks after leaving area. Adults, 100 mg daily; children, 2 mg/kg up to 100 mg daily (not for children <8 years old)
Chloroquine: Begin 1–2 weeks before arrival and continue for 4 weeks after leaving area. Adults, 300 mg base (500 mg salt) weekly; children, 5 mg base/kg weekly up to 300 mg:
- Caution: Chloroquine-resistant areas
Primaquine: Begin 1–2 days before arrival and continue for 1 week after leaving area; adults 30 mg/d; children, 0.5 mg/kg/d up to adult dose

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