Table 2.

Commonly used agents for antimalarial prophylaxis

	Treatment Recommendations	Contraindications	Target Population
Atovaquone-proguanil	Prevention and treatment of chloroquine-resistant P falciparum	Not recommended for pregnant or breastfeeding women, children <11 kg, or patients with impaired renal function	Last-minute travelers or travelers with short-term exposure to endemic regions Well-tolerated but may be more expensive than other options
Doxycycline	Can be used for prophylaxis but not treatment	Contraindicated in children <8 y old and pregnant women Gastrointestinal discomfort and sun sensitivity are common	Daily dosing, inexpensive option, suitable for last-minute travelers
Mefloquine	Effective against chloroquine-resistant parasites	Safe during pregnancy but not approved by the US Food and Drug Administration for children weighing <5 kg or younger than 6 mo Neuropsychiatric effects can be pronounced, contraindicated in patients with seizure disorders or cardiac conduction abnormalities	Weekly dosing regimen, preferred for long-term travelers
Primaquine	Recommended for prophylaxis in areas with P vivax malaria	Cannot be taken by pregnant or breast-feeding women Testing is necessary to exclude patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency	Daily dosing
Chloroquine	Limited use due to widespread resistance	Safe for infants, young children, and pregnant women	Weekly dosing, must be started 1–2 wk before travel