When treating chloroquine-resistant P. falciparum malaria, what is recommended?

The recommended treatment for chloroquine-resistant P. falciparum malaria is Artemisinin-based Combination Therapy (ACT). This treatment utilizes the synergistic effects of artemisinin derivatives, which are potent antimalarial agents, in combination with other antimalarial medications to improve efficacy and reduce the risk of resistance.

ACTs have become the standard of care in areas where P. falciparum has developed resistance to chloroquine, which limits the effectiveness of that drug. The use of combination therapy helps to ensure a more effective eradication of the malaria parasites from the bloodstream and minimizes the likelihood of resistance overcoming the treatment.

In contrast, chloroquine remains effective in regions where malaria is not resistant, but in cases of resistance, it is not suitable. The other medications listed are not used for treating malaria: clarithromycin and ethambutol are antibiotics primarily indicated for Mycobacterial infections, and mebendazole is an anthelmintic used to treat worm infections. Therefore, within the context of treating chloroquine-resistant P. falciparum malaria, ACT is the most appropriate and effective choice.