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June 17, 1983

Treatment of Chloroquine-Resistant Malaria During Pregnancy

Author Affiliations

From the Departments of Obstetrics and Gynecology (Drs E. Main and D. Main) and Medicine and Pathology (Dr Krogstad), Washington University School of Medicine, St Louis. Drs E. Main and D. Main are now with the University of Pennsylvania, Philadelphia.

JAMA. 1983;249(23):3207-3209. doi:10.1001/jama.1983.03330470047030

A pregnant 36-year-old Vietnamese refugee with chloroquine-resistant Plasmodium falciparum infection was treated with pyrimethamine and a sulfonamide. This treatment produced rapid clearance of the patient's parasitemia and was associated with a resumption of normal fetal and uterine growth. Because the other drugs effective against chloroquine-resistant P falciparum may produce uterine stimulation (quinine sulfate) or damage the fetal skeleton (tetracyclines), the pyrimethamine-sulfonamide combination (with folinic acid supplementation) may be the best available choice for the treatment and prophylaxis of chloroquine-resistant P falciparum infection in pregnancy, despite its theoretical risk of teratogenicity.

(JAMA 1983;249:3207-3209)