Chloroquine may be the drug of choice, but only in areas where chloroquine-sensitive P. falciparum organisms are present. Chloroquine prophylaxis is no longer effective for travel to many regions. Daily atovaquone-proguanil appears to be the first choice for chemoprophylaxis for travel to areas of chloroquine resistance. Prophylactic drugs, such as chloroquine or mefloquine, should be started 2 to 4 weeks prior to travel and continued for 6 to 8 weeks after leaving the endemic areas. The atovaquone-proguanil combination is the exception in that it is started 1 to 2 days prior to departure and is continued 1 week after return.
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