Table 4.
| Malaria species | Trimester | Treatment | Directions for use | Special notes |
|---|---|---|---|---|
| P. falciparum | First | Quinine and clindamycin | 7-day treatment | Quinine can be used alone and can be used if clindamycin is not available. In cases of failure or unavailability, artemisinin-based combination therapy or oral artesunate with clindamycin can be used for 7 days, as artemisinin derivatives have not shown risk for major congenital defects |
| Non-falciparum malaria | First | Chloroquine | As described in Table 3 | Can be replaced with quinine for chloroquine-resistant infections |
| P. falciparum | Second and third | ACTs as the first-line treatment, the same as for nonpregnant adults | Any ACTs can be used in pregnancy | The mean birthweight was significantly higher in patients using ACTs, as ACTs might clear parasites (including placental parasites) more efficiently than other treatments |