Duke B O
Bull World Health Organ. 1968;39(2):157-67.
Suramin and Mel W are the only two drugs at present known to be effective against the adult worms of Onchocerca volvulus, but in view of the unpredictable occurrence of fatal arsenical encephalopathy in a small proportion of patients receiving Mel W, suramin remains the preferred macrofilaricide in the treatment of onchocerciasis. It is therefore important to determine the suramin dosage schedules that will produce parasitological cures with minimal concomitant risks of toxic reactions. The criteria by which cures should be judged must also be appreciated.Courses of different duration and employing doses of 1.0 g, 0.5 g and 0.25 g suramin have been investigated for their action on adult worms and microfilariae, for the toxic reactions which they produce on the kidney, and for the level of suramin reached in the serum during treatment. A course of 5 or 6 weekly doses of 1.0 g has been shown to be the optimum for adults.It is sometimes stated without good foundation that different brands of suramin differ in their purity and chemical composition, thus producing inconsistent effects on the parasites and grave risks of toxic manifestations. The three main brands in current use in Africa (Antrypol, Moranyl and Naganol) have therefore been compared in a group of patients, using the same optimum dosage schedule for each preparation and recording the action of the various brands on the parasites, as well as their comparative toxicities and the serum suramin levels achieved. No significant differences between the brands were recorded.
苏拉明和美拉胂醇是目前已知的仅有的两种对盘尾丝虫成虫有效的药物，但鉴于一小部分接受美拉胂醇治疗的患者会不可预测地发生致命性砷性脑病，在治疗盘尾丝虫病时，苏拉明仍是首选的杀成虫药物。因此，确定能实现寄生虫学治愈且同时将毒性反应风险降至最低的苏拉明给药方案很重要。还必须了解用于判断治愈的标准。已对不同疗程以及采用1.0克、0.5克和0.25克苏拉明剂量的情况进行了研究，观察其对成虫和微丝蚴的作用、对肾脏产生的毒性反应以及治疗期间血清中达到的苏拉明水平。已证明，对于成年人来说，每周服用1.0克、共5或6剂的疗程是最佳的。有时毫无根据的说法是，不同品牌的苏拉明在纯度和化学成分上存在差异，因此对寄生虫产生的效果不一致，且有出现毒性表现的严重风险。因此，在一组患者中对目前在非洲使用的三种主要品牌（安锥赛、莫拉胂醇和纳加诺尔）进行了比较，每种制剂都采用相同的最佳给药方案，并记录各品牌对寄生虫的作用以及它们的相对毒性和所达到的血清苏拉明水平。各品牌之间未记录到显著差异。
