Abstract
A pregnant 36-year-old Vietnamese refugee with chloroquine-resistant<i>Plasmodium falciparum</i>infection was treated with pyrimethamine and a sulfonamide. This treatment produced rapid clearance of the patient's parasitemia and was associated with a resumption of normal fetal and uterine growth. Because the other drugs effective against chloroquine-resistant<i>P falciparum</i>may produce uterine stimulation (quinine sulfate) or damage the fetal skeleton (tetracyclines), the pyrimethamine-sulfonamide combination (with folinic acid supplementation) may be the best available choice for the treatment and prophylaxis of chloroquine-resistant<i>P falciparum</i>infection in pregnancy, despite its theoretical risk of teratogenicity. (<i>JAMA</i>1983;249:3207-3209)
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