P. Vivax with Typhi IgG +ve CBC -WNL What would be best? cefixime 200 + oflox200bd lariago kit

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For P.Vivax If non complicated CHQ 500 mg 2 tabs stat f/b 1 tab after 6,24 & 36 hrs after first dose. Primaquine 30 mg/day PO for 14 days ( CDC USA & GOVT of india recommendations) Artemether-lumefantrine -(20 mg artemether and 120 mg lumefantrine) total doses over 3 days. On day 1, the initial dose is given and then second dose is 8 hours later. On days 2 and 3, doses are given BID. Should be evaluated on case to case basis & local CHQ resistance prevalence. For complicated P.Vivax CHQ & primaquine as described above with Inj artesunate 120mgIV at 0 hr, 12 hr, 24 hr, and 48 hr For typhi IgG+ no active Rx required as If the IgG is positive but the IgM is low or negative, then it is likely that the person had an infection sometime in the past.
Mam, for primaquine the dosage that I know and read from standard books is - For vivax - 0.25mg/kgBW for 14 days, which means a 60kg adult has to take primaquine 15mg OD for 14 days. For falciparum - 0.75mg/kgbw at Day 2, which means a 60kg adult has to take primaquine 45 mg at Day 2. For mixed - its same as vivax for 14 days Kindly give your opinion on this mam. One more thing mam, Do you always do G6PD for every patient like everyone is suggesting here ? I always check the Hb status and for females asking for pregnancy to decide whether to give primaquine or not.
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Lariago ds course with g6 pd test then malirid ds od 14 days igg previous infection or sulfamethaxole pyrimethamine stat artesunate100 bd 3 days
Preferably admission, Inj.artesunate 120mg stat iv followed by 60mg iv is for 5 days with inj. Ceftriaxone 1gm iv bd *5 days...then use primaquin
After glucose 6 phosphatase test , give lariago ds 2 tabs stat and 15 mg primaquin daily for 5days. Typhi IgG is not active typhoid
These days,Typhoid has become resistant to conventional doses . Cefixime 400 mg + ofloxacin 400 mg B.D ( Tab Ceftas - O - DS ) for 2 weeks will cure typhoid and also prevent recurrence. For Plasmodium vivax - Tab Artesunate + mefloquine O.D for 3 days followed tab primaquine 15 mg O.D for 2 weeks- but get G6PD tested before starting primaquine
Inj Falcigo 120mg bd for first day f/b 120 mg od x 5 more days - test for parsitic index ,g6pd test, tab primaquine x 15 days.
Agree with your treatment

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