Markwalder K, Hatz C
Konsiliarius für Tropenmedizin, Departement Innere Medizin, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1998 Sep 5;128(36):1313-27.
A review of the principal antimalarial drugs is presented as the basis for specific recommendations on the treatment of malaria. These are adapted to conditions in Switzerland. Considering that the majority of Plasmodium falciparum infections imported into this country are acquired in areas with a high prevalence of chloroquine resistance, mefloquine is generally considered the first-line drug for the treatment of uncomplicated falciparum malaria. For severe tropical malaria, or if parasitaemia exceeds 2%, quinine remains the drug of choice. The pharmacological decision must estimate the risk of drug-resistant malaria and consider the clinical condition, possible intolerance and drug interactions. Prognosis is always difficult in falciparum malaria; hence hospitalization is always strongly recommended if the course is in doubt and if close monitoring of the patient is not otherwise guaranteed. In hospital, ancillary treatment (e.g. exchange transfusion) must receive timely consideration. Special considerations must be borne in mind with regard to the treatment of malaria in children and during pregnancy.
本文介绍了主要抗疟药物，作为疟疾治疗具体建议的基础。这些建议适用于瑞士的情况。鉴于该国输入的大多数恶性疟原虫感染是在氯喹耐药性高发地区获得的，甲氟喹通常被视为治疗非复杂性恶性疟疾的一线药物。对于严重热带疟疾，或寄生虫血症超过2%的情况，奎宁仍是首选药物。药理学决策必须评估耐多药疟疾的风险，并考虑临床状况、可能的不耐受性和药物相互作用。恶性疟疾的预后总是很困难；因此，如果病程有疑问且无法保证对患者进行密切监测，强烈建议住院治疗。在医院里，必须及时考虑辅助治疗（如换血）。在儿童疟疾治疗和孕期疟疾治疗方面，必须牢记特殊注意事项。
