Preventive Treatment of Malaria During Pregnancy: The Optimal Strategy Remains Unclear

Dihydroartemisinin-piperaquine did not improve pregnancy outcomes over sulfadoxine-pyrimethamine; adding azithromycin to dihydroartemisinin-piperaquine also did not improve results.

Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (S-P) is recommended in malaria-endemic regions, but parasitic resistance to S-P compromises its effectiveness. Dihydroartemisinin-piperaquine (D-P) is superior to S-P in preventing malaria — but will D-P, alone or with azithromycin, lead to better pregnancy outcomes? In a double-blind trial in Kenya, Malawi, and Tanzania, HIV-negative women with singleton pregnancies at 16–28 weeks' gestation were randomly assigned to receive monthly IPTp with S-P (single dose; 500 mg sulfadoxine, 25 mg pyrimethamine), D-P (dosed by body weight for 3 consecutive days), or D-P plus single-course azithromycin (500 mg daily for 2 consecutive days). About 17% had sexually tran…

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

Preventive Treatment of Malaria During Pregnancy: The Optimal Strategy Remains Unclear

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Reviewing Author