Recommendations for chemoprophylaxis depend on local patterns of susceptibility to antimalarials
and the likelihood of acquisition of malaria. When uncertainty exists, drugs that effectively prevent infection with resistant P falciparum should be used—ie, atovaquone–proguanil, doxycycline, primaquine, or mefloquine. Chemo prophylaxis is never completely reliable, and malaria should always be a possible diag nosis in febrile patients who have travelled to endemic areas.