Page 56 - Medical Parasitology_ A Textbook ( PDFDrive )

48 6 Malaria Parasites and Babesia

Table 6.1 Treatment for malaria
First line Alternative
Uncomplicated Riamet (1 tablet: 20 mg Artesunate/Mefloquine (AS + MQ
malaria artemether/120 mg lumefantrine) Fixed Dose Combination (FDC)
Tablet)
A 3-day treatment schedule with a
total of 6 doses is recommended 2 FDC strength—25 mg AS/55 MQ
and 100 mg AS/220 mg MQ
The patient should receive an initial
dose followed by the 2nd dose 8 h A 3-day treatment schedule, once
later, then 1 dose BD for the daily regime
following 2 days
5–8 kg: 1 tablet of 25 mg AS/55 mg
5–<15 kg: 1 tablet per dose MQ
15–<25 kg: 2 tablets per dose 9–17 kg: 2 tablets 25mg AS/55 mg
25–<35 kg: 3 tablets per dose MQ
≥35 kg: 4 tablets per dose 18–29 kg: 1 tablet of 100 mg
AS/220 mg MQ
In P. vivax and P. ovale infection, ≥30 kg: 2 tablets of 100mg
primaquine 0.5 mg/kg (max 30 mg) AS/220 mg MQ
OD for 14 days
Or
Oral Quinine (10 mg/kg) 8 hourly
with oral Doxycycline 100 mg BD
for 7 days
Complicated Day 1 IV Artesunate 2.4 mg/kg at 0, Day 1 (Loading dose)
malaria 12, 24 h, and daily subsequently till IV Quinine 20 mg salt/kg over
day 7 a 4 hours in D5%

And Or
Oral Doxycycline 100 mg BD (given IV Quinine 7 mg salt/kg over 1 h
together with IV Artesunate) followed by 10 mg salt/kg over 4 h
Then,
IV Quinine 10 mg/kg 8 hourly (can
give orally if tolerated) for 7 days
And
Oral Doxycycline 100 mg BD for
7 days
Adapted from Management Guidelines of Malaria in Malaysia 2013, Ministry of Health
Malaysia
This guideline has been revised and updated based on previous national guidelines (published in
year 1993) and the 2nd edition of WHO guidelines)
a Parenteral artesunate should be given for a minimum of 24 h (3 doses) or until patient can tolerate
orally then it can be switched to a complete course of oral ACT either Riamet or AS + MQ. For all
stages of pregnancy: IV Artesunate is given as for normal adults.

Babesia

Babesia are intraerythrocytic sporozoan parasites that morphologically resemble P.
falciparum. It is a tick-borne parasite.