Treatment of chloroquine-resistant malaria during pregnancy.
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.
D000328:Adult; D002738:Chloroquine / Q000494:pharmacology*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008288:Malaria / Q000188:drug therapy*; D010963:Plasmodium falciparum / Q000187:drug effects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011739:Pyrimethamine / Q000008:administration & dosage*; D013417:Sulfameter / Q000008:administration & dosage*; D013424:Sulfanilamides / Q000008:administration & dosage*
D013424:Sulfanilamides; D013417:Sulfameter; D002738:Chloroquine; D011739:Pyrimethamine