Спросите в индонезийском разделе, если кто там есть сейчас из форумчан, может узнают, есть ли в аптеках маларон.
В отношении лечения - довольно сложно его самостоятельно подобрать.
Во-первых, местная чувствительность плазмодиев к препаратам. Допустим, в интернете можно посмотреть по статьям в специальной литературе (индонезийским, конечно). Но ведь она меняется, различается по территориям.
Во-вторых, довольно много смешанной инфекции, т.е. заражение несколькими видами плазмодиев. Т.е. все же нужна диагностика.
В-третьих, лечение еще не все, нужен мониторинг некоторых показателей, возможный только в мед. учреждении.
Если, не дай Бог, заражение - лучше к врачу.
Тем не менее, дам Вам немного информации по лечению, если хотите.
Источник: medscape (образовательный спец. ресурс). Я так понимаю, с английским у Вас без проблем.
P falciparum drug resistance is common in endemic areas, such as Africa. Standard antimalarials, such as chloroquine and antifolates (sulfadoxine-pyrimethamine), are ineffective in many areas. Because of this increasing prevalence of drug resistance and a high likelihood of resistance development to new agents, combination therapy is now becoming the standard of care for treatment of P falciparum infection worldwide. In April 2009, the US Food and Drug Administration (FDA) approved the use of artemisinins, a new class of antimalarial agent.[20]
Despite the activity of artemisinin and its derivatives, monotherapy with these agents has been associated with high rates of relapse. This may be due to the temporary arrest of the growth of ring-stage parasites (dormancy) after exposure to artemisinin drugs. For this reason, monotherapy with artemisinin drugs is not recommended.[21] Rectal artesunate has been used for pretreatment of children in resource-limited settings as a bridge therapy until the patient can access health care facilities for definitive IV or oral therapy.[22]
Despite their being a fairly new antimalarial class, resistance to artemisinins has been reported in some parts of southeast Asia (Cambodia).[23]
In the United States, artemether and lumefantrine tablets (Coartem) can be used to treat acute uncomplicated malaria. Artesunate, a form of artemisinin that can be used intravenously, is available from the Centers for Disease Control and Prevention (CDC). Other combinations, such as atovaquone and proguanil HCL (Malarone) or quinine in combination with doxycycline or clindamycin, remain highly efficacious. Malaria vaccine production and distribution continues to be in the research and development stage.[24, 25, 26]
When making treatment decisions, it is essential to consider the possibility of coinfection with more than 1 species. Reports of P knowlesi infection suggest that coinfection is common.[5] It has also been demonstrated that up to 39% of patients infected with this species may develop severe malaria. In cases of severe P knowlesi malaria, IV therapy with quinine or artesunate is recommended.[6]
The following is a summary of general recommendations for the treatment of malaria:
P falciparum malaria - Quinine-based therapy is with quinine (or quinidine) sulfate plus doxycycline or clindamycin or pyrimethamine-sulfadoxine; alternative therapies are artemether-lumefantrine, atovaquone-proguanil, or mefloquine
P falciparum malaria with known chloroquine susceptibility (only a few areas in Central America and the Middle East) - Chloroquine
P vivax, P ovale malaria - Chloroquine plus primaquine; however, a 2012 study of Indonesian soldiers demonstrated that primaquine combined with newer nonchloroquine antimalarials killed dormant P vivax parasites and prevented malaria relapse;[27, 28] the combination of dihydroartemisinin-piperaquine with primaquine had 98% efficacy against relapse, suggesting that this regimen could become a useful alternative to primaquine plus chloroquine, the clinical utility of which is being threatened by worsening chloroquine resistance
P malariae malaria - Chloroquine
P knowlesi malaria – Recommendations same as those for P falciparum malaria.
Я не в том возрасте, когда неосознанно делают глупости.
Я в том, когда их делают осознанно и с удовольствием.
