| Uncomplicated falciparum malaria |
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First trimester
Chloroquine-susceptible:
Chloroquine phosphate, 600 mg base (=1000 mg salt) orally, followed by 300 mg base orally at 6, 24, and 48 hours for a total dose of 1500 mg base Hydroxychloroquine, 620 mg base (=800 mg salt) orally, followed by 310 mg base orally at 6, 24, and 48 hours for a total dose of 1550 mg base
Chloroquine-resistant:
Quinine 10 mg/kg plus clindamycin 5 mg/kg three times per day, × 7 days Artesunate 2 mg/kg per day plus clindamycin 5 mg/kg three times per day, × 7 days
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Second or third trimester
Artesunate 2 mg/kg per day plus clindamycin 5 mg/kg three times per day, × 7 days Quinine 10 mg/kg plus clindamycin 5 mg/kg three times per day, × 7 days
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| Severe malaria |
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Quinidine gluconate 6.25 mg base loading dose over 1–2 hours followed by 0.0125 mg base/kg continuous infusion, plus clindamycin for at least 24 hours, and until parasitemia is <1%. Treatment may be completed with oral quinine plus clindamycin. Treat patients for 3 days if disease was acquired in Africa or South America, and for 7 days if acquired in South-East Asia
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Artesunate 2 mg/kg per day plus clindamycin 5 mg/kg three times per day, × 7 days
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| Other antimalarial agents |
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Artemisinin combination treatments (ACTs) , such as arthemether–lumefantrine, artesunate–amodiaquine, artesunate–mefloquine, and artesunate–sulfadoxine-pyramethamine, have been used extensively outside the United States, but should be avoided during the first trimester
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Atovaquone-proguanil tablets, 250 mg atovaquone/100 mg proguanil each, × 4 tablets orally per day × 3 days
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