Cook G C
Hospital for Tropical Diseases, London, England.
Drug Saf. 1995 Jul;13(1):31-45. doi: 10.2165/00002018-199513010-00005.
Traditionally, many of the chemotherapeutic agents used in tropical medicine have possessed limited efficacy and serious adverse effects. This scenario has been revolutionised by the introduction into clinical parasitology of the benzimidazole compounds, praziquantel (and other schistosomicidal agents) and ivermectin for helminthiases, and the 5-nitroimidazoles for protozoan infections. An effective armamentarium against Plasmodium spp. infections, especially P. falciparum, is receding as widespread multiple drug resistance becomes commonplace. Although management of several more exotic parasitic infections, including trypanosomiasis, leishmaniasis and onchocerciasis remains unsatisfactory, several newer and relatively non-toxic preparations (including eflornithine and ivermectin) are now available, and offer optimism. However, there remains a very long way to go before a single preparation is available to combat all major protozoan and/or helminthic infections; such an agent would also need to be 100% effective when given as a single dose, safe not only in the healthy adult but also during pregnancy and lactation, stable at high ambient temperature and relatively low in cost.
传统上，热带医学中使用的许多化疗药物疗效有限且副作用严重。苯并咪唑类化合物、吡喹酮（及其他抗血吸虫药）和伊维菌素用于治疗蠕虫病，5-硝基咪唑类用于治疗原生动物感染，这些药物引入临床寄生虫学后，这种情况发生了变革。随着多重耐药性的广泛出现，针对疟原虫感染，尤其是恶性疟原虫感染的有效药物储备正在减少。虽然包括锥虫病、利什曼病和盘尾丝虫病在内的几种较为罕见的寄生虫感染的治疗仍不尽人意，但现在有了几种更新的、相对无毒的制剂（包括依氟鸟氨酸和伊维菌素），带来了希望。然而，要找到一种单一制剂来对抗所有主要的原生动物和/或蠕虫感染，还有很长的路要走；这样一种药物还需要单剂量给药时100%有效，不仅对健康成年人安全，对孕妇和哺乳期妇女也安全，在高温环境下稳定且成本相对较低。
