Stand-By Emergency Treatment (SBET) may be indicated in certain situations as a temporary stop-gap measure until definitive medical care can be given.
The ideal candidate is someone traveling to a remote location or in a situation where access to medical care is not readily available.
A person considering the use of SBET should
(1) take steps to prevent mosquito bites
(2) take appropriate antimalarial prophylaxis.
The person must take the medication after making a presumptive diagnosis of malaria based on fever, chills or influenza-like symptoms starting 1 week or more after entering the region.
The drug used for SBET must:
(1) be different than the drug(s) used for prophylaxis
(2) not have drug interactions with the prophylactic drugs
(3) not be associated with drug resistant strains in the region
Medical care must be sought immediately after starting SBET.
Prophylactic Regimen
Some Possible Choices for SBET
none
mefloquine or quinine or atovaquone/proguanil; chloroquine can be used for a P. vivax area only
chloroquine with or without proguanil
mefloquine or quinine
mefloquine
quinine and doxycycline
doxycycline
mefloquine
atovaquone plus proguanil
quinine and doxycycline
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