g / Pyrimethamine

< vSulfadoxine

Tetracyclines Class II

o /Atovaquone sj ^Proguanil

Class III


FIGURE 39-2 Spectrum of clinically useful activity for antimalarial drugs. For atovaquone and proguanil, reliable activity against the primary liver stage has been shown for P. falciparum only; for the class I agents, activity against gametocytes does not include P falciparum.

treatment of established infection and not used for prophylaxis in healthy travelers. Chloroquine is relatively safe and has a 1-week t1/2 that is convenient for prophylaxis (in those few areas where chloroquine-sensitive malaria persists).

Causal prophylactics act on the initial hepatic stages, drugs for terminal prophylaxis and radical cure target hypnozoites, and agents for suppressive prophylaxis or cure target the asexual red cell forms. Regimens currently recommended for prophylaxis in nonimmune individuals are given in Table 39-1, and regimens for the treatment of malaria are given in Table 39-2.

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