Page 184 - HPP ANTIMICROBIAL GUIDELINE 2018
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Suggested Treatment
                       Infection/ Condition                                                                                         Comments
                                                               Preferred                         Alternative

                 Malaria


                 Uncomplicated malaria            Riamet®                             Quinine 10mg/kg PO q8h             Give a single dose of primaquine
                 All Plasmodium species           (Artemether/ lumefantrine 20/120mg)  PLUS                              0.25 mg/kg  with ACT to patients with
                                                  4 tablets stat,                     Doxycycline 100mg PO q12h for      P. falciparum malaria
                                                              nd
                                                  followed by 2  dose 8 hours later,   7 days                            (except pregnant women,
                                                  then 4 tablets q12h for 2 days.                                         infants aged < 6 months and
                                                                                      OR                                 women breastfeeding
                                                  Total: 24 tablets                                                      infants aged < 6 months)
                                                                                      Quinine 10mg/kg PO q8h             to reduce transmission.
                                                                                      PLUS                               G6PD testing is not required.
                                                                                      ƚ  Clindamycin 600mg PO q12h for
                                                                                      7 days                             ƚ  For pregnancy, doxycycline should
                                                                                                                         not be used
                 P. vivax/P. ovale                PLUS
                                                  Primaquine 0.5mg/kg for 14 days
                                                  (Need to check for G6PD)


                 Complicated                      Artesunate 2.4mg/kg IV at 0 hour,    Loading dose Quinine 20mg/kg IV   *Parenteral artesunate should be
                                                  12 hour, 24 hour and q24h till day 7*   over 4 hours in D5% on day 1, then   given for a minimum of 24 hours
                                                                                      quinine 10mg/kg IV/PO q8h          (3 doses) or until patient can tolerate
                                                                                      (renal adjustment is required)     orally then it can be switched to a
                                                                                                                         complete course of oral ACT regime,
                                                                                                                         eg: Riamet®
                                                                                      PLUS
                                                                                      Doxycycline 100mg PO q12h for 7    In severe malaria, add single dose
                                                                                      days                               primaquine in areas of low
                                                                                                                         transmission.








               HPP AMG                                                       Tropical Infections                                                         87
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