Toxoplasmosis, azithromycin effect

Two other agents show promise in treatment of ocular toxoplasmosis. Atovaquone, primarily used for mild to moderate episodes of Pneumocystis carinii pneumonia, has been effective in small series of patients with toxoplasmosis. It appears to have activity against both tachy-zoites and tissue cysts. More recent studies on atovaquone in toxoplasmosis are limited to murine models, and no further reports on this drug therapy in humans have been published. Azithromycin, a macrolide antibiotic, is efficacious against T. gondii and can also kill tissue cysts. A randomized study of 46 patients compared the combinations of azithromycin plus pyrimethamine versus pyrimethamine plus sulfadiazine in treatment of ocular toxoplasmosis efficacy was similar, but the azithromycin/ pyrimethamine regimen caused less adverse effects. 

Trichomoniases immunologicaNy normal patient. Pyrimethamine with sulfadiazine for chorioretinitis.and active toxoplasmosis in imimmodeficicnt patients foilnic add is used to counteract the inevitable megaloblastic anaemia. Alternatives include pyrimethamine with clindamycin or clarithromycin or azithromycin Spiramycin for primary toxoplasmosis in pregnant women. Expert advice is essential. Metronidazole or tinidazole is effective... 

In a prospective, randomized, open, multicenter trial of pyrimethamine -I- azithromycin versus pyrimethamine + snlfadiazine for the treatment of ocular toxoplasmosis in 46 patients with sight-threatening ocular toxoplasmosis, the two regimens had similar efficacy however, the adverse effects were significantly less common and severe with pyrimethamine + azithromycin (2). 

In vitro studies have shown that azithromycin is active against Toxoplasma gondii, and that this activity is additive with pyrimethamine [291]. In vivo studies have shown that azithromycin has some prophylactic and therapeutic activity [292-294]. Only a handful of human cases of cerebral toxoplasmosis treated with azithromycin have been described in the hterature [295-297]. Early results with escalating doses of oral azithromyein of 900, 1200, or 1500 mg daily plus pyrimethamine in 32 evaluable patients with known or suspected toxoplasma encephalitis have been reported [298]. It was concluded that azithromycin plus pyrimethamine is not as effective as the standard therapy for cerebral toxoplasmosis and should be regarded as second-line or salvage therapy. 

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