Page 185 - HPP ANTIMICROBIAL GUIDELINE 2018

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