Doxycycline is an effective prophylactic agent against chloroquine-resistant malaria.
Indications:
(1) travel to chloroquine resistant areas, especially when mefloquine or primaquine cannot be used
(2) travel to chloroquine and mefloquine resistant areas (Thai-Cambodian border, and Thai-Myanmar border, western Cambodia)
Contraindications:
(1) use in pregnant women
(2) children < 8 years of age
(3) hypersensitivity
Age of the Patient |
Daily Dose |
adult |
100 mg per day |
child >= 8 years old |
2 mg/kg per day, up to 100 mg |
Instructions:
(1) begin dose 1 day prior to travel, continue during travel, and for 4 weeks after leaving malarious region
(2) bismuth subsalicylate for traveler's diarrhea can interfere with absorption
Toxicity:
(1) gastrointestinal tract disturbances
(2) photosensitivity
(3) vaginal Candida infections
Primaquine phosphate may be added to the regimen to protect against P. vivax and P. ovale if there has been an exposure after departure:
(1) dose
(1a) adult: 28.3 mg per day (15 mg base)
(1b) children: 0.3 mg base per kg per day up to 15 mg base
(2) It is administered during the last 2 weeks of prophylaxis with doxycycline.
(3) It is contraindicated in pregnancy.
(4) It may cause hemolytic anemia in G6PD deficient individuals.
Specialty: Infectious Diseases, Pharmacology, clinical