Shoemaker Ritchie C, Hudnell H Kenneth, House Dennis E, Van Kempen Amy, Pakes Gary E
Center for Research on Biotoxin-Associated Illnesses Pocomoke City, Maryland 21851, USA.
Adv Ther. 2006 Jan-Feb;23(1):1-11. doi: 10.1007/BF02850341.
Ten percent of US patients with Lyme disease are coinfected with Babesia microti. A double-blind, placebo-controlled, crossover trial enrolled 25 patients with confirmed Borrelia burgdorferi/B microti coinfection, abnormal visual contrast sensitivity (VCS), and persistent symptoms despite prior treatment with atovaquone and azithromycin. Patients were randomly assigned to atovaquone suspension or placebo plus cholestyramine for 3 weeks, were crossed over for 3 weeks, and then received open-label atovaquone and cholestyramine for 6 weeks. Symptoms and VCS scores were recorded at baseline and after weeks 3, 6, 9, and 12. Improvements in symptoms and VCS deficits were observed only after at least 9 weeks of treatment. At week 12, 5 patients were asymptomatic, and 16 had a notable reduction in the number of symptoms. The entire cohort demonstrated significant increases in VCS scores. Adverse effects were rare. Patients coinfected with B burgdorferi and B microti derive measurable clinical benefit from prolonged treatment with atovaquone and cholestyramine. Longer-term combination therapy may be indicated.
美国10%的莱姆病患者同时感染微小巴贝斯虫。一项双盲、安慰剂对照、交叉试验招募了25名确诊为伯氏疏螺旋体/微小巴贝斯虫合并感染、视觉对比敏感度（VCS）异常且尽管先前接受过阿托伐醌和阿奇霉素治疗仍有持续症状的患者。患者被随机分配接受阿托伐醌混悬液或安慰剂加考来烯胺治疗3周，交叉治疗3周，然后接受开放标签的阿托伐醌和考来烯胺治疗6周。在基线以及第3、6、9和12周后记录症状和VCS评分。仅在至少9周的治疗后观察到症状和VCS缺陷有所改善。在第12周时，5名患者无症状，16名患者的症状数量显著减少。整个队列的VCS评分显著提高。不良反应罕见。伯氏疏螺旋体和微小巴贝斯虫合并感染的患者通过长期接受阿托伐醌和考来烯胺治疗可获得可测量的临床益处。可能需要长期联合治疗。
