An American couple decide to travel to Sub Saharan Africa this summer. They visit their family physician for prophylaxis against malaria. Their past history indicates that they both had severe nausea and dizziness when they took mefloquine in a previous trip to West Africa and they had to discontinue their medication.

Which of these recommendation is acceptable alternative for mefloquine prophylaxis for this couple?

A- No need for prophylaxis as they already acquired immunity during their previous visit

B- Prescribe doxycycline and use of sun protection

C- Prescribe chloroquine to avoid side effects

D- Prescribe mefloquine and do not use it unless there is active infection

E- Recommend travel to other malaria-free regions




Answer:

Chloroquine is acceptable alternative for mefloquine. Chloroquine has much more side effects for these patients than mefloquine. Prophylaxis is crucial in endemic areas to avoid malaria infection. It is not recommended to counsel your patients to change their plans.

The correct answer is B