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 what is the chemoprophylaxis for  

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hey guys
what is the chemoprophylaxis for malaria in pregnant pts?

i was going through kaplan IM preventive med part (page 2) and it says 'for patients who are pregnant and require chemoprophylaxis for malaria, the combination of atovaquone and proguanil is the preferred regimen'

and when i googled i reached this site:

which says: 'Atovaquone-proguanil is not recommended for prophylaxis in children weighing <5 kg (11 lb), pregnant women, or patients with severe renal impairment (creatinine clearance <30 mL/min).'

what is the answer? plz help!!


found the answer in same link by cdc

Chemoprophylaxis during Pregnancy and Breastfeeding

Malaria infection in pregnant women can be more severe than in non-pregnant women. Malaria can increase the risk for adverse pregnancy outcomes, including prematurity, spontaneous abortion, and stillbirth. For these reasons, and because no chemoprophylaxis regimen is completely effective, women who are pregnant or likely to become pregnant should be advised to avoid travel to areas with malaria transmission if possible (see Chapter 8, Pregnant Travelers). If travel to a malarious area cannot be deferred, use of an effective chemoprophylaxis regimen is essential.
Pregnant women traveling to areas where chloroquine-resistant P. falciparum has not been reported may take chloroquine prophylaxis. Chloroquine has not been found to have any harmful effects on the fetus when used in the recommended doses for malaria prophylaxis; therefore, pregnancy is not a contraindication for malaria prophylaxis with chloroquine phosphate or hydroxychloroquine sulfate. For travel to areas where chloroquine resistance is present, mefloquine is the only medication recommended for malaria chemoprophylaxis during pregnancy. In 2011, the FDA reviewed available data for mefloquine use during pregnancy and reclassified it from category C (animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks) to category B (animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women).


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