Quinine for the Treatment of Malaria in Pregnancy
Adoke Yeka and colleagues1 rightly call for the
discontinuation of quinine monotherapy in sub-
Saharan Africa. However, combination therapies using
quinine for the treatment of uncomplicated malaria in
pregnancy were discounted. We agree that artemether
with lumefantrine, azithromycin, artesunate with
mefl oquine, or dihydroartemisinin with piperaquine
should be investigated for their potential use in the
treatment of pregnant women with uncomplicated
malaria.1 However, with the exception of azithromycin,
all of these compounds are contraindicated in the fi rst
trimester. Priority should be given to investigating
treatment regimens including azithromycin with
quinine and azithromycin with chloroquine that are safe
for use throughout pregnancy.
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