Page 270 - HPP ANTIMICROBIAL GUIDELINE 2018

Infection/Condition Suggested Treatment Comments
Preferred Alternative

c) Complicated
- Almost always due to P. D1: Artesunate 2.4 mg/kg IV on admission, then Artesunate 4mg/kg PO q24h
falciparum repeat again at 12h PLUS
- Always suspect mixed Clindamycin 10mg/kg PO q12h for 7 days
infections if vivax / knowlesi D2-7: Artesunate 2.4 mg/kg IV q24h or switch to
malaria appear more severe oral ACT OR
than usual
Quinine 10mg salt/kg PO q8h
PLUS
Clindamycin 10mg/kg PO q12h for 7 days

D1: Quinine loading dose 7mg/kg IV over 1
hour, followed by 10mg/kg in 250ml D5%
over 4 hours

OR
D1: Quinine loading dose 20mg/kg IV in 250ml
D5% over 4 hours

Then,
D2-7: Quinine 10mg/kg IV q8h on day 2 -7

PLUS
For children >8yr:
Doxycycline 3.5mg/kg PO q24h for 7 days

OR
For children <8yr:
Clindamycin 10mg/kg PO q12h for 7 days

HPP AMG Tropical Infections 130