tailieunhanh - INFECTIOUS DISEASES - PART 7

Đối với phụ nữ trong tam cá nguyệt đầu tiên của họ, hầu hết các bằng chứng cho thấy rằng việc sử dụng của mefloquine là không liên quan với những kết quả bất lợi, bào thai hoặc mang thai, chẳng hạn như sảy thai, thai chết lưu, dị tật bẩm sinh khi dùng ở liều dự phòng, | or likely to become pregnant should try to avoid travel to areas where they could contract malaria. Women traveling to areas where drug-resistant P falciparum has not been reported may take chloroquine prophylaxis. Harmful effects on the fetus have not been demonstrated when chloroquine is given in the recommended doses for malaria prophylaxis. Pregnancy therefore is not a contraindication for malaria prophylaxis with chloroquine. For pregnant women who travel to areas where chloroquine-resistant P falciparum exists mefloquine should be recommended for chemoprophylaxis during the second and third trimesters. For women in their first trimester most evidence suggests that use of mefloquine is not associated with adverse fetal or pregnancy outcomes such as spontaneous abortions stillbirths and birth defects when taken in prophylactic doses but more data are necessary to make conclusive statements about its safety in early pregnancy. Consequently mefloquine is the drug of choice for prophylactic use for women who are pregnant or likely to become pregnant when exposure to chloroquine-resistant P falciparum is unavoidable. Self-treatment of Malaria. Malaria can be treated effectively early in the course of disease but delay of appropriate treatment can have serious or even fatal consequences. Travelers who do not take an antimalarial drug for prophylaxis or who are on a less-than-effective regimen or who may be in very remote areas can be given a self-treatment course of atovaquone-proguanil. Travelers should be advised that self-treatment is not considered a replacement for seeking prompt medical help. A self-treatment regimen should be discussed with a physician expert in travel medicine before departure. Travelers taking atovaquone-proguanil as their antimalarial drug regimen should not take atovaquone-proguanil as their self-treatment drug and should use an alternative treatment regimen the CDC Malaria Hotline 770-4887788 provides advice on management of travelers .