關於抗瘧藥
Quinine, chloroquine, amodiaquine, pyrimethamine, sulphadoxine, proguanil, mefloquine, primaquine, artemesinin and its derivatives, halofantrine, doxycycline and clindamycin are all drugs that are used alone or in various combinations to treat or prevent malaria.
Halofantrine (marketed under various commercial names such as Halfan) is widely used in many places to treat malaria. It is not used to prevent malaria because of the risk of toxicity and unreliable absorption.
Recently, malaria strains resistant to all known drugs, including artemesinin and its derivatives, have been identified along the Thai/Myanmar (Burma) border.
For preventing malaria while travelling in a malarious area, the most commonly recommended medications are Malarone (atovaquone/proguanil) or doxycycline. However, it is important to realize that different strains of malaria occur in different parts of the world and the type of malaria medicine prescribed should match the part of the world that you are visiting. No antimalarial drug is 100% protective and they should be combined with the use of personal protective measures such as insect repellent, long sleeves, long pants, sleeping in a mosquito-free setting or using an insecticide-treated bednet.
Malarone
Malarone is the trade name for atovaquone and proguanil. It is effective for all parts of the world. The adult dose is usually one tablet daily, starting one or two days before travelling into an area containing malaria. The dose should continue throughout the stay and then for another 7 days after leaving the malaria containing area. The dose for a child is usually prescribed according to body weight. Users should consult with their physician. Malarone should be taken with a fatty meal or some milk so that it is adequately absorbed.
Malarone is usually the choice for short trips to malaria containing areas because it usually produces far fewer side effects than other malaria drugs. Few people may experience side effects such as cough, headache, loss of appetite, mouth sores, nausea, stomach pain, diarrhoea, vomiting, weakness, and dizziness.
Doxycycline
Doxycycline is an antibiotic that prevents the development of parasites in the blood that cause malaria.
To prevent malaria, the recommended dose for doxycycline is 1 to 2 days before you travel to an area where malaria is present, daily while you are in that area, and daily for 4 weeks after you leave the area. It is best to take the tablets with food. Doxycycline is often cheaper than Malarone and for this reason it can be prescribed for long trips in a malaria endemic area.
Side effects may of doxycycline might include: anorexia, nausea, diarrhoea, thrush, sore tongue (glossitis), headaches, blurred vision or tinnitus. The side effect of Erythema (sun burn) due to sunlight photosensitivity is particularly important for those intending long-term use for malaria prevention.
