Treatment regimens for pregnant women with falciparum malaria

Abstract

Relevant studies, primarily those published since 2010, were identified from reference databases and were used to identify secondary data sources. Expert commentary: WHO recommends use of intravenous artesunate for severe malaria, quinine-clindamycin for uncomplicated malaria in first trimester, and artemisinin combination therapy for uncomplicated malaria in second/third trimesters. Because fear of adverse outcomes has often excluded pregnant women from conventional drug development, available data for novel therapies are usually based on preclinical studies and cases of inadvertent exposure. Changes in antimalarial drug disposition in pregnancy have been observed but are yet to be translated into specific treatment recommendations. Such targeted regimens may become important as parasite resistance demands that drug exposure is optimized.

Antimalarial drugs for treating and preventing malaria in pregnant and lactating women

“…There are only three studies assessing the PCR-corrected efficacy of ASAQ in pregnancy including around 750 women in the second and third trimesters in Africa [69,75,76]. PCR-corrected ACPR by day 28, 42 and 63 were all reported > 95% [10], although this high efficacy may not be achievable in Asia where resistance of amodiaquine is more prevalent [77].…”