MALARIA TREATMENT 1998

A review of the principal antimalarial drugs is presented as the basis for specific recommendations on the treatment of malaria. These are a dapted to conditions in Switzerland. Considering that the majority of Plasmodium faciparum infections imported into this country are acquire d in areas with a high prevalence of chloroquine resistance, mefloquin e is generally considered the first-line drug for the treatment of unc omplicated falciparum malaria. For severe tropical malaria, or if para sitaemia exceeds 2%, quinine remains the drug of choice. The pharmacol ogical decision must estimate the risk of drug-resistant malaria and c onsider the clinical condition, possible intolerance and drug interact ions. Prognosis is always difficult in falciparum malaria; hence hospi talization is always strongly recommended if the course is in doubt an d if close monitoring of the patient is not otherwise guaranteed. In h ospital, ancillary treatment (e.g. exchange transfusion) must receive timely consideration. Special considerations must be borne in mind wit h regard to the treatment of malaria in children and during pregnancy. The pharmacological decision must estimate the risk of drug-resistant malaria and consider the clinical condition, possible intolerance and drug interactions. Prognosis is always difficult in falciparum malaria ; hence hospitalization is always strongly recommended if the course i s in doubt and if close monitoring of the patient is not otherwise gua ranteed. In hospital, ancillary treatment (e.g. exchange transfusion) must receive timely consideration. Special considerations must be born e in mind with regard to the treatment of malaria in children and duri ng pregnancy.