The World Health Organization (WHO) recommends<unk>  or one of its derivatives ― typically in combination with a longer-lasting partner drug ― as frontline therapy for all cases of malaria. For uncomplicated malaria, the WHO recommends three days of oral treatment with any of five<unk> -based combination therapies (ACTs):<unk> emether/lumefantrine,<unk> esunate/amodiaquine (ASAQ),<unk> esunate/mefloquine, dihydroartemisinin/piperaquine, or<unk> esunate/sulfadoxine/pyrimethamine. In each of these combinations, the<unk>  derivative rapidly kills the parasites, but is itself rapidly cleared from the body. The longer-lived partner drug kills the remaining parasites and provides some lingering protection from reinfection. For severe malaria, the WHO recommends intravenous or intramuscular treatment with the<unk>  derivative<unk> esunate for at least 24 hours.<unk> esunate treatment is continued until the treated person is well enough to take oral medication. They are then given a three-day course of an ACT, as for uncomplicated malaria. Where<unk> esunate is not available, the WHO recommends intramuscular injection of the less potent<unk>  derivative<unk> emether. For children less than six years old, if injected<unk> esunate is not available the WHO recommends rectal administration of<unk> esunate, followed by referral to a facility with the resources for further care.<unk> s are not used for malaria prevention because of the extremely short activity (half-life) of the drug. To be effective, it would have to be administered multiple times each day. Contraindications The WHO recommends avoiding ACT for women in their first trimester of pregnancy due to a lack of research on<unk> 's safety in early pregnancy. Instead the WHO recommends a seven-day course of clindamycin and quinine. For pregnant women in their second or third trimesters, the WHO recommends a normal treatment course with an ACT. For some other groups, certain ACTs are avoided due to side effects of the partner drug: sulfadoxine-pyrimethamine is avoided during the first few weeks of life as it interferes with the action of bilirubin and can worsen neonatal jaundice. In HIV-positive people, the combination of trimethoprim/sulfamethoxazole, zidovudine-containing antiretroviral treatments, and ASAQ is associated with neutropenia. The combination of the HIV drug efavirenz and ASAQ is associated with liver toxicity.
Artemisinin
Artemether
Quinine
Ajmalicine
Proguanil
Dihydroartemisinin
Chloroquine
Deoxygedunin