Malaria can be a severe, potentially fatal disease (especially when caused by Plasmodium falciparum) and treatment should be initiated as soon as possible.
Patients who have severe P. falciparum malaria or who cannot take oral medications should be given the treatment by continuous intravenous infusion.
Most drugs used in treatment are active against the parasite forms in the blood (the form that causes disease) and include:
- atovaquone-proguanil (Malarone®)
- artemether-lumefantrine (Coartem®)
- mefloquine (Lariam®)
- doxycycline (used in combination with quinine)
- clindamycin (used in combination with quinine)
- artesunate (not licensed for use in the United States, but available through the CDC malaria hotline)
In addition, primaquine is active against the dormant parasite liver forms (hypnozoites) and prevents relapses. Primaquine should not be taken by pregnant women or by people who are deficient in G6PD (glucose-6-phosphate dehydrogenase). Patients should not take primaquine until a screening test has excluded G6PD deficiency.