Artesunate for injection (Amivas LLC), a semi-synthetic artemisinin derivative, is now approved by the FDA for initial (induction) treatment of severe malaria in children and adults. It has been available from the CDC on a compassionate use basis since 2007. Artemether/lumefantrine (Coartem), another artemisinin-based drug, was approved earlier for oral treatment of uncomplicated Plasmodium falciparum malaria. IV artesunate is now the only FDA-approved injectable antimalarial drug available in the US; IV quinidine has been discontinued.

Patients who receive pretravel advice can reduce their risk for many travel-related conditions. Vaccines recommended for travelers are reviewed in a separate issue.

Patients planning to travel to other countries often ask for information about appropriate vaccines and prevention of diarrhea and malaria. More detailed advice for travelers is available from the Centers for Disease Control and Prevention (CDC) at www.cdc.gov/travel. Guidelines are also available from the Infectious Diseases Society of America (IDSA).

Patients planning to travel to other countries often ask physicians for information about appropriate vaccines and prevention of diarrhea and malaria. Guidelines are also available from the Infectious Diseases Society of America (IDSA).

Patients planning to travel to other countries often ask physicians for information about immunizations and prevention of diarrhea and malaria. More detailed advice for travelers is available from the Centers for Disease Control and Prevention at 877-FYI-TRIP (877-394-8747) or www.cdc.gov/travel.

Many patients planning to travel seek advice about prevention of malaria. No drug is 100% effective for this indication; travelers should be told to take other protective measures as well. Malaria in pregnancy is particularly serious for both mother and fetus; prophylaxis is indicated if travel cannot be avoided. Countries with a risk of malaria are listed in the table on page 102. Some countries with endemic malaria transmission may not have malaria in the most frequently visited major cities and rural tourist resorts.

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Patients planning to travel often ask for advice on prophylaxis against malaria. None of the antimalarials used in the past for prophylaxis has been entirely satisfactory.

Results of recently completed clinical trials have led to some changes in recommendation for treatment of human immunodeficiency virus (HIV) and other infections associated with AIDS.

Results of recently completed clinical trials have led to some changes in recommendations for treatment of human immunodeficiency virus (HIV) and other infections associted with AIDS.

Atovaquone (Mepron - Burroughs Wellcome), a hydroxynaphthoquinone, was recently approved by the US Food and Drug Administration (FDA) for oral treatment of mild to moderate Pneumocystis carinii pneumonia (PCP) in patients who cannot tolerate trimethoprim-sulfamethoxazole (Septra, Bactrim, and others). PCP is a common opportunistic infection and frequent cause of death in patients with AIDS.

A growing number of clinical trials now permits some consensus on the treatment of human immunodeficiency virus (HIV) and other infections associated with acquired immune deficiency syndrome (AIDS) in adults.

Mefloquine hydrochloride (Lariam - Roche), a new antimalarial drug chemically related to quinine, has been approved by the US Food and Drug Administration (FDA) for prevention and treatment of Plasmodium falciparum and P. vivax malaria.