Page 271 - HPP ANTIMICROBIAL GUIDELINE 2018
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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
