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Uncomplicated malaria

Species

Medication & Dose

Comment

P. falciparum��or unidentified species

Artemether-lumefantrine (1 tablet = 20 mg artemether/120 mg lumefantrine)
5-14 kg: 1 tablet��
15-24 kg: 2 tablets��
25-34 kg: 3 tablets��
>35 kg: 4 tablets (adult dose)��orally with fatty food, full-fat milk, or breastmilk
At 0, 8, 24, 36, 48 and 60 hours��

Discuss alternatives with Infectious Disease if Artemether-lumefantrine not available

Outpatient management may be suitable if adherence to antimalarials can be assured

P. vivax,��P. ovale, P. malariae, and P. knowlesi

All regions except if suspected chloroquine-resistant��P. vivax��( see below)

Doses are expressed in chloroquine base
Chloroquine (1 tablet = 155 mg base = 250 mg chloroquine phosphate)
10 mg/kg (max 620 mg) orally at 0 hours, then��
5 mg/kg (max 310 mg) orally at 6, 24, and 48 hours��
and follow up with
Primaquine for P. vivax or P. ovale or unknown species

Chloroquine is available in Australia through .

Round dose to the nearest ¼ tablet

Hydroxycholoroquine or artemether-lumefantrine are alternatives

Exclude G6PD deficiency before starting Primaquine - if deficient, consult Infectious Diseases��

P. vivax malaria��with known chloroquine resistance

Artemether-lumefantrine as above for uncomplicated��P. falciparum����
and
Primaquine ( see below)

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Severe malaria

Severe malaria����
Any species
or��
inability to tolerate oral therapy

Artesunate 2.4 mg/kg IV/IM (bolus dose over 1-2 minutes) on admission��

Repeat at 12 hours and 24 hours, then once daily until oral therapy tolerated (complete full oral course as above)

Available through��

Maintain strict fluid balance - avoid fluid overload - cerebral/pulmonary oedema

Complex administration – please contact pharmacy

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When patient is able to tolerate oral therapy, change to Artemether-lumefantrine (dosage as above)

Discuss alternatives with Infectious Disease if Artemether-lumefantrine not available

Species

Primaquine dose (for children >6 months of age)

Doses are expressed in terms of primaquine base;
7.5 mg primaquine base is equivalent to 13.2 mg primaquine phosphate

Tablet strength = 7.5 mg

Exclude G6PD deficiency before starting Primaquine

P. vivax

0.5 mg/kg (max 30 mg) orally daily with food for 14 days (or divided 12 hourly if causing nausea)

P. ovale

0.5 mg/kg (max 30 mg) orally daily with food for 14 days

Species unknown

0.5 mg/kg (max 30 mg) orally daily with food for 14 days (or divided 12 hourly if causing nausea)

G6PD deficiency

Consult Infectious Diseases