Corrections



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Am Fam Physician. 2000 Jan 1;61(1):50-52.

Table 1 in the article “Malaria Prevention in Travelers” (May 1, 1999, page 2523) contained an error in the pediatric dosage of mefloquine. The correct pediatric dosage is based on a 250-mg tablet, like the adult dosage. The table with corrected pediatric dosages is published on page 52.

TABLE 1

Drugs for Malaria Prophylaxis

Drug Areas of effective use Adult dosage Pediatric dosage Use in pregnancy

Chloroquine (Aralen)

Middle East, Central America (west of Panama Canal) and Hispaniola (especially Haiti)

300-mg base (500-mg salt) orally once a week starting one week before travel, once weekly during exposure and once weekly for four weeks after return home

Same weekly regimen as for adults but dosage is as follows: 5 mg per kg base (8.3 mg per kg salt), to a maximum of 300-mg base

Yes

Mefloquine (Lariam)

Areas of chloroquine- resistant malaria (South America, Asia, Africa, India and Oceania [Pacific islands and New Guinea])

250-mg salt using the same regimen as for chloroquine

Same weekly regimen as for adults but dosages are as follows:

Usually not in first trimester

Less than 15 kg (33 lb): 5 mg per kg salt 15 to 19 kg (33 to 42 lb): one fourth of a 250-mg salt tablet per week 20 to 30 kg (44 to 66 lb): one half of a 250-mg salt tablet per week 31 to 45 kg (68 to 99 lb): three fourths of a 250-mg salt tablet per week

May be used in second and third trimesters if use is warranted based on risk and the pregnant woman is unable to postpone travel plans

More than 45 kg (99 lb): one 500-mg salt tablet per week

Proguanil (Paludrine; not available in the United States)

Less effective alternative to mefloquine in sub-Saharan Africa; used with weekly chloroquine dose

200 mg per day after food

Less than two years: 50 mg per day Two to six years:100 mg per day Seven to 10 years:150 mg per day Older than 10 years: 200 mg per day

Yes, with folate supplementation

Doxycycline (Vibramycin)

Reasonable alternative to mefloquine in areas with mefloquine-resistant Plasmodium strains or when mefloquine is contraindicated

100 mg per day during exposure and for four weeks after return home

Contraindicated in children less than nine years old

No

Otherwise, regimen is the same as for adults

Primaquine

Terminal prophylaxis if at risk for relapsing type of malaria or for elimination of Plasmodium species in persons who travel for more than two months in a high-risk area

15-mg base (26.3-mg salt) per day for 14 days before return home

0.3 mg per kg base (0.5 mg per kg salt) per day for 14 days

No

Pyrimethamine-sulfadoxine (Fansidar)

No longer used for prophylaxis

Three tablets as a single dose

5 to 10 kg (11 to 22 lb): one-half tablet (single dose) 11 to 20 kg (24 to 44 lb): one tablet (single dose) 21 to 30 kg (46 to 66 lb): one and one-half tablets (single dose) 31 to 45 kg (68 to 99 lb): two tablets (single dose)

Not in first or third trimesters

Self-treatment if in remote setting or if on inadequate prophylaxis

More than 45 kg (99 lb): three tablets (single dose)


Adapted from Health information for international travel, 1996–97. Atlanta: Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Infectious Diseases, Division of Quarantine, 1997. HHS publication no. 95–8280.

TABLE 1   Drugs for Malaria Prophylaxis

View Table

TABLE 1

Drugs for Malaria Prophylaxis

Drug Areas of effective use Adult dosage Pediatric dosage Use in pregnancy

Chloroquine (Aralen)

Middle East, Central America (west of Panama Canal) and Hispaniola (especially Haiti)

300-mg base (500-mg salt) orally once a week starting one week before travel, once weekly during exposure and once weekly for four weeks after return home

Same weekly regimen as for adults but dosage is as follows: 5 mg per kg base (8.3 mg per kg salt), to a maximum of 300-mg base

Yes

Mefloquine (Lariam)

Areas of chloroquine- resistant malaria (South America, Asia, Africa, India and Oceania [Pacific islands and New Guinea])

250-mg salt using the same regimen as for chloroquine

Same weekly regimen as for adults but dosages are as follows:

Usually not in first trimester

Less than 15 kg (33 lb): 5 mg per kg salt 15 to 19 kg (33 to 42 lb): one fourth of a 250-mg salt tablet per week 20 to 30 kg (44 to 66 lb): one half of a 250-mg salt tablet per week 31 to 45 kg (68 to 99 lb): three fourths of a 250-mg salt tablet per week

May be used in second and third trimesters if use is warranted based on risk and the pregnant woman is unable to postpone travel plans

More than 45 kg (99 lb): one 500-mg salt tablet per week

Proguanil (Paludrine; not available in the United States)

Less effective alternative to mefloquine in sub-Saharan Africa; used with weekly chloroquine dose

200 mg per day after food

Less than two years: 50 mg per day Two to six years:100 mg per day Seven to 10 years:150 mg per day Older than 10 years: 200 mg per day

Yes, with folate supplementation

Doxycycline (Vibramycin)

Reasonable alternative to mefloquine in areas with mefloquine-resistant Plasmodium strains or when mefloquine is contraindicated

100 mg per day during exposure and for four weeks after return home

Contraindicated in children less than nine years old

No

Otherwise, regimen is the same as for adults

Primaquine

Terminal prophylaxis if at risk for relapsing type of malaria or for elimination of Plasmodium species in persons who travel for more than two months in a high-risk area

15-mg base (26.3-mg salt) per day for 14 days before return home

0.3 mg per kg base (0.5 mg per kg salt) per day for 14 days

No

Pyrimethamine-sulfadoxine (Fansidar)

No longer used for prophylaxis

Three tablets as a single dose

5 to 10 kg (11 to 22 lb): one-half tablet (single dose) 11 to 20 kg (24 to 44 lb): one tablet (single dose) 21 to 30 kg (46 to 66 lb): one and one-half tablets (single dose) 31 to 45 kg (68 to 99 lb): two tablets (single dose)

Not in first or third trimesters

Self-treatment if in remote setting or if on inadequate prophylaxis

More than 45 kg (99 lb): three tablets (single dose)


Adapted from Health information for international travel, 1996–97. Atlanta: Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Infectious Diseases, Division of Quarantine, 1997. HHS publication no. 95–8280.


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