[Malaria prophylaxis: what is safe?]

Plasmodium falciparum is resistant to proguanil, chloroquine and pyrimethamine/sulfadoxine (Fansidar) in many parts of the world. It can be assumed that in the future resistance to mefloquine and quinine will also increase. This will have important consequences for the recommended schemes for drug prophylaxis. No new drugs suitable for prophylaxis will be on the market in the near future. Neither the combination of mefloquine with pyrimethamine/sulfadoxine (Fansimef) nor the new drug halofantrine will solve the impending problems. It has to be accepted that no absolute protection against malaria infection can be guaranteed by the presently available drugs. In regions with low transmission no permanent prophylaxis but only a standby therapy is recommended. Moreover, personal protection against mosquitoes with pyrethrum-impregnated bed-nets and repellents will gain importance.