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Am Fam Physician. 2000;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.

DrugAreas of effective useAdult dosagePediatric dosageUse 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 homeSame 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 baseYes
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 chloroquineSame 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 weekMay 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 dose200 mg per day after foodLess 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 dayYes, with folate supplementation
Doxycycline (Vibramycin)Reasonable alternative to mefloquine in areas with mefloquine-resistant Plasmodium strains or when mefloquine is contraindicated100 mg per day during exposure and for four weeks after return homeContraindicated in children less than nine years oldNo
Otherwise, regimen is the same as for adults
PrimaquineTerminal 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 area15-mg base (26.3-mg salt) per day for 14 days before return home0.3 mg per kg base (0.5 mg per kg salt) per day for 14 daysNo
Pyrimethamine-sulfadoxine (Fansidar)No longer used for prophylaxisThree tablets as a single dose5 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)

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