♨️ مقال

📌روشتات د. ماجد المبشر ( للأطباء فقط) / Malaria Treatment روشتة علاج الملاريا.

✍️ د. ماجد المبشر

🦟 Malaria Treatment علاج الملاريا 

1️⃣ Severe (Complicated) Falciparum Malaria

First Line: IV Artesunate

<20 kg → 3 mg/kg IV

≥20 kg → 2.4 mg/kg IV

Schedule: 0 hr → 12 hr → 24 hr → then every 24 hr (max 7 days)

Switch to oral when improving:

Artemether + Lumefantrine (Riamet®) — 6 doses at 0, 8, 24, 36, 48, 60 hr

Alternative: Atovaquone-Proguanil (Malarone®) or Oral Quinine

If Artesunate unavailable:

IV Quinine:

Loading: 20 mg/kg infusion over 4 hr

Maintenance: 10 mg/kg every 8 hr infusion over 4 hr

Add second agent:

<12 yrs → Clindamycin 7–13 mg/kg every 8 hr

≥12 yrs → Doxycycline 200 mg once daily

2️⃣ Uncomplicated Malaria

Oral therapy if patient can tolerate:

Artemether + Lumefantrine (Riamet®)

Weight. Dose. Total Tablets

5–14 kg 1 tab. 6

15–24 kg 2 tabs. 12

25–34 kg 3 tabs. 18

≥35 kg. 4 tabs. 24

Atovaquone-Proguanil (Malarone®) — 3 days

Weight Dose

5–8 kg. 2 paed tabs

9–10 kg. 3 paed tabs

11–20 kg. 1 standard tab

21–30 kg. 2 standard tabs

31–40 kg. 3 standard tabs

>40 kg 4 standard tabs

Quinine Sulphate — oral alternative

10 mg/kg every 8 hr (max 600 mg)

Duration: 7 days or until blood films negative

Add second agent:

 <12 yrs → Clindamycin 7–13 mg/kg every 8 hr;

 ≥12 yrs → Doxycycline 200 mg daily

3️⃣ Non-Falciparum Malaria (vivax, ovale)

Artemether + Lumefantrine same as uncomplicated

Add Primaquine after checking G6PD:

Species Dose Duration

P. vivax 0.5 mg/kg/day 14 days

P. ovale 0.25 mg/kg/day 14 days

Mild G6PD deficiency → weekly primaquine ×8 weeks

Severe deficiency or <6 months → consult infectious disease specialist