Uncomplicated:
No evidence of organ dysfunction
Parasitemia <5%
Able to tolerate PO
Hospitalize:
Severe clinical manifestations in non-immune host for P. falciparum or P. knowlesi
Report to state health department
For non-pregnant patients (3 day course)
Artemether + lumefantrine
Artesunate + amodiaquine
Artesunate + mefloquine
Dihydroartemisinin + piperaquine
Artesunate + sulfadoxine–pyrimethamine (SP)
For pregnant (1st trimester)
Quinine + clindamycin x 7 days
Additional considerations
Avoid artesunate + SP in HIV/AIDS patients taking co-trimoxazole
Avoid artesunate + amodiaquine in HIV/AIDS patients taking efavirenz or zidovudine
P. vivax and P. ovale have dormant hypnozoites in the liver which require treatment with primaquine phosphate for complete eradication
No evidence of organ dysfunction
Parasitemia <5%
Able to tolerate PO
Severe clinical manifestations in non-immune host for P. falciparum or P. knowlesi
Artemether + lumefantrine
Artesunate + amodiaquine
Artesunate + mefloquine
Dihydroartemisinin + piperaquine
Artesunate + sulfadoxine–pyrimethamine (SP)
Quinine + clindamycin x 7 days
Avoid artesunate + SP in HIV/AIDS patients taking co-trimoxazole
Avoid artesunate + amodiaquine in HIV/AIDS patients taking efavirenz or zidovudine
P. vivax and P. ovale have dormant hypnozoites in the liver which require treatment with primaquine phosphate for complete eradication
Do not delay treatment in the unstable patient if strong suspicion for malaria as initial smear may be falsely negative
Treatment (IV for ≥24 hours then 3 days PO course)
Artesunate (IV)
Clears malaria faster than quinine
Distributed only through CDC
Quinidine (IV) also appropriate choice; more available in US
Artesunate (IV)
Clears malaria faster than quinine
Distributed only through CDC
Quinidine (IV) also appropriate choice; more available in US
Clears malaria faster than quinine
Distributed only through CDC
Arthropod and parasitic antibiotics
Bioterrorism antibiotics
Aminoglycosides
Beta-lactams
Tetracyclines
Immunocompromised antibiotics
Fluoroquinolones
Skin and soft tissue antibiotics