MIND LINES AGAINST GUIDELINES IN TREATMENT OF MALARIA …
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malaria.
Sulfadoxine/pyrimethamine and artemether/lumefentrine are
recommended as first line drugs for treatment of confirmed cases of
Plasmodium.falciparum. Chloroquine along with premaquine combination is used
as anti relapse therapeutic agents in case of
Plasmodium.vivax
(4) (Table 1).
Table 1.-‐
Standard treatment guidelines for malaria in Pakistan.
Anti-malarial drugs
Dosag
form
Comments
Chloroquine is first choice of drug in all cases of malaria when type not confirmed
through laboratory test for empiriacl therapy
Standard treatment regimen for
P.vivax
Chloroquine
+
primaquine
Tablets
Chloroquine 25mg/kg for 3days + primaquine
0.25mg/kg O.D for 14 days.
Primaquine
Tablets
0.75mg/kg body weight once a week for 8weeks.
Standard treatment regimen for confirmed cases of
P.falciparum
Artemether
+lumefantrine
Tablets
Artemether 20mg +lumefantrine 120mg two
doses per day for 3 days.
Artesunate
+tetracycline
Tablets
Artesunate 20mg /kg O.D +tetracycline 4mg/kg
Q.I.D for 7days.
Dihydroartemisinin+
piperaquine
Tablets
Dihydroartemisinin 4mg/kg/day +piperaquine
18mg/kg/day for 3days.
Single
dose
piperaquine
Tablets
(0.75 mg/kg) to ACT treatment
*Directorate of Malaria Control and WHO, National treatment guidelines for malaria. 2005
Although, standard treatment guidelines are available in the country, still
prescribing and dispensing practices are not up to the desired standards in public
and private healthcare facilities in Pakistan (5).
There is lack of research on evaluating the adherence of prescribing
practices with these standard treatment guidelines, which in turn has strong
influence on malaria treatment practices (6). Therefore, the main objective of the
present study was to assess the adherence of prescribers with national standard
treatment guidelines for malaria in the two cities of Pakistan; Islamabad (national
capital) and in its twin city Rawalpindi.
The study will provide baseline data regarding adherence of prescribers
with standard treatment guidelines, which can serve as a basis for potential areas
for intervention to implement the standard treatment guidelines effectively to
improve rational drug use in the healthcare system.
