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1.4.1

Second-line Treatment — Artesunate-Amodiaquine (ASAQ)

Guidelines for the Treatment of Malaria in Malawi, 6th Edition, 2025. Chapter 2, Uncomplicated Malaria.

Treatment

The recommended second-line treatment for uncomplicated malaria in Malawi is artesunate-amodiaquine (ASAQ). It is available in fixed-dose combinations with tablets containing 25 mg/67.5 mg, 50 mg/135 mg and 100 mg/270 mg of artesunate and amodiaquine, respectively. The recommended total treatment dose per day is 4 mg/kg/day of artesunate and 10 mg/kg/day of amodiaquine given once a day for 3 days.

Do not give Artesunate-Amodiaquine in HIV positive patients who are taking zidovudine, cotrimoxazole and efavirenz. Instead give quinine and clindamycin.

Table 1.5 — Dosage schedule for fixed combination dose of artesunate-amodiaquine
Table 1.5 — Dosage schedule for fixed combination dose of artesunate-amodiaquine. Open the image to zoom.

Confirmed treatment failures with ASAQ should be treated with quinine and doxycycline for seven days if not contraindicated. For children under 8 years, give oral quinine and clindamycin. For children weighing less than 5 kg with treatment failure to LA or DP, they should be given ASAQ.

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