Artemisinin-Based Antimalarials to Replace First-Trimester Quinine Treatment

Based on safety, effectiveness, and tolerability, artemisinin-lumefantrine is preferred for uncomplicated falciparum malaria in early pregnancy.

Malaria during early pregnancy can impair placental development, leading to fetal growth restriction, preterm birth, and low birth weight. Until late 2022, WHO-recommended treatment of first-trimester falciparum malaria was quinine plus clindamycin — but is that the best choice? In a systematic review of studies with individual patient data encompassing 34,178 pregnancies, investigators evaluated adverse outcomes after artemisinin-based treatment (ABT) versus non-ABT for uncomplicated first-trimester falciparum malaria.

Adverse pregnancy outcomes (a composite of miscarriage, stillbirth, and major congenital anomalies) occurred in 5.7% of 736 ABT-exposed and 8.9% of 1074 non–ABT-exposed pregnancies. Most ABT courses consisted of artemether-lu…

Reviewing Author

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Artemisinin-Based Antimalarials to Replace First-Trimester Quinine Treatment

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Reviewing Author