. Author manuscript; available in PMC: 2020 Oct 15.

Published in final edited form as: Obstet Gynecol Surv. 2019 Sep;74(9):546–556. doi: 10.1097/OGX.0000000000000704

Table 7:

Severe Malaria Treatment

Generic Name	Dose Regimen
Quinidine Gluconate	• 6.25 mg base/kg (10 mg salt/kg) loading dose IV over 1–2 hours, then 0.0125 mg base/kg/min (0.02 mg salt/kg/min) continuous infusion for at least 24 hours. • An alternative regimen is 15 mg base/kg (24 mg salt/kg) loading dose IV infused over 4 hours, followed by 7.5 mg base/kg (12 mg salt/kg) infused over 4 hours every 8 hours, starting 8 hours after the loading dose (see package insert). • Once parasite density <1% and patient can take oral medication, complete treatment with oral quinine, dose as above in Table 5. • Course of Quinidine/Quinine: 7 days for Southeast Asia and 3 days everywhere else.
Clindamycin	• 20mg base/kg/day PO divided into TID dosing for 7 days • If patient not able to take oral medication, give 10mg base/kg loading dose IV followed by 5mg base/kg IV every 8 hours. • Switch to oral clindamycin as soon as patient can take oral medication. For IV use, avoid rapid administration. • Treatment course is 7 days.

Generic Name

Dose Regimen

Quinidine Gluconate

• 6.25 mg base/kg (10 mg salt/kg) loading dose IV over 1–2 hours, then 0.0125 mg base/kg/min (0.02 mg salt/kg/min) continuous infusion for at least 24 hours.
• An alternative regimen is 15 mg base/kg (24 mg salt/kg) loading dose IV infused over 4 hours, followed by 7.5 mg base/kg (12 mg salt/kg) infused over 4 hours every 8 hours, starting 8 hours after the loading dose (see package insert).
• Once parasite density <1% and patient can take oral medication, complete treatment with oral quinine, dose as above in Table 5.
• Course of Quinidine/Quinine: 7 days for Southeast Asia and 3 days everywhere else.

Clindamycin

• 20mg base/kg/day PO divided into TID dosing for 7 days
• If patient not able to take oral medication, give 10mg base/kg loading dose IV followed by 5mg base/kg IV every 8 hours.
• Switch to oral clindamycin as soon as patient can take oral medication. For IV use, avoid rapid administration.
• Treatment course is 7 days.

Adapted from CDC Guidelines¹¹.