treatment of uncomplicated (mild) malarial infection
Last reviewed 02/2023
Seek expert advice.
Treatment is dependent on organism and resistance.
Treatment of non falciparum malariae - P. vivax, P. ovale or P. malariae:
- chloroquine
- used for the treatment of acute vivax, ovale and malariae malaria
- adults - initially 600mg then 300mg after 6-8 hours, then 300mg on days 2 & 3
- children - initially 10mg/kg/base then 5mg/kg/base 6-8 hours later and on day 2 & 3
- can also be used for retreatment in case of a relapse
- chloroquine resistant vivax malaria - quinine/co-artem/atovaquone-proguanil are effective.
- in P. vivax and P. ovale:
- relapse may occur due to persistent hepatic forms - hypnozoites
- treatment with antimalarials should be followed with a course of primaquine
to prevent relapse (to eliminate hypnozoites in ovale or vivax malaria)
- for P.ovale - 15 mg daily for 14 days to
- for P. vivax - 30 mg daily for 14 days
- contraindicated in pregnancy (1)
Treatment of falciparum malaria - P. falciparum
- The 3 main clinical options for uncomplicated falciparum malaria treatment
are
- oral quinine plus doxycycline (or quinine plus clindamycin in certain circumstances e.g.- pregnant women and young children) - taken for 5-7 days
- co-artem (artemetherelumefantrine) - to be taken for 3 days
- atovaquone-proguanil (Malarone) - to be taken for 3 days
- Due to the side effects and high rate of non-completion of courses, the British Infectious Society does not recommend mefloquine as a form of therapy in UK
- Chloroquine is NOT recommended for the treatment of falciparum malaria (1)
Emergency standby treatment should be recommended for those taking chemoprophylaxis and visiting remote areas where they are unlikely to be within 24 hours of medical attention (2)- see linked item
Advice on specific problems is available from a number of centres whose telephone numbers are listed in section 5.4 of the BNF.
The summary of product characteristics should be consulted before prescribing the drugs prescribed.
Reference:
chloroquine in P. vivax, P. ovale or P. malariae