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Updated CDC Recommendations for Using Artemether-Lumefantrine for the Treatment of Uncomplicated Malaria in Pregnant Women in the United States.

Abstract Malaria infection during pregnancy is associated with an increased risk for maternal and fetal complications. In the United States, treatment options for uncomplicated, chloroquine-resistant Plasmodium falciparum and P. vivax malaria in pregnant women are limited to mefloquine or quinine plus clindamycin (1). However, limited availability of quinine and increasing resistance to mefloquine restrict these options. Strong evidence now demonstrates that artemether-lumefantrine (AL) (Coartem) is effective and safe in the treatment of malaria in pregnancy. The World Health Organization (WHO) has endorsed artemisinin-based combination therapies (ACTs), such as AL, for treatment of uncomplicated malaria during the second and third trimesters of pregnancy and is currently considering whether to add ACTs, including AL, as an option for malaria treatment during the first trimester (2,3). This policy note reviews the evidence and updates CDC recommendations to include AL as a treatment option for uncomplicated malaria during the second and third trimesters of pregnancy and during the first trimester of pregnancy when other treatment options are unavailable. These updated recommendations reflect current evidence and are consistent with WHO treatment guidelines.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title mmwr. morbidity and mortality weekly report
Publication Year Start




PMID- 29649190
OWN - NLM
STAT- MEDLINE
DCOM- 20180413
LR  - 20180418
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Linking)
VI  - 67
IP  - 14
DP  - 2018 Apr 13
TI  - Updated CDC Recommendations for Using Artemether-Lumefantrine for the Treatment
      of Uncomplicated Malaria in Pregnant Women in the United States.
PG  - 424-431
LID - 10.15585/mmwr.mm6714a4 [doi]
AB  - Malaria infection during pregnancy is associated with an increased risk for
      maternal and fetal complications. In the United States, treatment options for
      uncomplicated, chloroquine-resistant Plasmodium falciparum and P. vivax malaria
      in pregnant women are limited to mefloquine or quinine plus clindamycin (1).
      However, limited availability of quinine and increasing resistance to mefloquine 
      restrict these options. Strong evidence now demonstrates that
      artemether-lumefantrine (AL) (Coartem) is effective and safe in the treatment of 
      malaria in pregnancy. The World Health Organization (WHO) has endorsed
      artemisinin-based combination therapies (ACTs), such as AL, for treatment of
      uncomplicated malaria during the second and third trimesters of pregnancy and is 
      currently considering whether to add ACTs, including AL, as an option for malaria
      treatment during the first trimester (2,3). This policy note reviews the evidence
      and updates CDC recommendations to include AL as a treatment option for
      uncomplicated malaria during the second and third trimesters of pregnancy and
      during the first trimester of pregnancy when other treatment options are
      unavailable. These updated recommendations reflect current evidence and are
      consistent with WHO treatment guidelines.
FAU - Ballard, Sarah-Blythe
AU  - Ballard SB
FAU - Salinger, Allison
AU  - Salinger A
CN  - MPHc
FAU - Arguin, Paul M
AU  - Arguin PM
FAU - Desai, Meghna
AU  - Desai M
FAU - Tan, Kathrine R
AU  - Tan KR
LA  - eng
PT  - Journal Article
PT  - Practice Guideline
DEP - 20180413
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
RN  - 0 (Antimalarials)
RN  - 0 (Artemisinins)
RN  - 0 (Drug Combinations)
RN  - 0 (Ethanolamines)
RN  - 0 (Fluorenes)
RN  - 0 (artemether-lumefantrine combination)
SB  - IM
MH  - Antimalarials/*therapeutic use
MH  - Artemisinins/*therapeutic use
MH  - Centers for Disease Control and Prevention (U.S.)
MH  - Drug Combinations
MH  - Ethanolamines/*therapeutic use
MH  - Female
MH  - Fluorenes/*therapeutic use
MH  - Humans
MH  - Malaria/*drug therapy
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/*drug therapy
MH  - United States
PMC - PMC5898222
COIS- No conflicts of interest were reported.
EDAT- 2018/04/13 06:00
MHDA- 2018/04/14 06:00
CRDT- 2018/04/13 06:00
PHST- 2018/04/13 06:00 [entrez]
PHST- 2018/04/13 06:00 [pubmed]
PHST- 2018/04/14 06:00 [medline]
AID - 10.15585/mmwr.mm6714a4 [doi]
PST - epublish
SO  - MMWR Morb Mortal Wkly Rep. 2018 Apr 13;67(14):424-431. doi:
      10.15585/mmwr.mm6714a4.