Derouin F
Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, Paris, France.
Pathol Biol (Paris). 1995 Jun;43(6):561-4.
Azithromycin can inhibit the growth of Toxoplasma gondii tachyzoïtes in vitro, but the effect is only observed with prolonged incubation with the drug, reflecting the delayed mode of action of this macrolide on the parasite. Azithromycin is probably acting by inhibition of protein synthesis but the site of action and fixation in the parasite has not been demonstrated. Azithromycin is also effective against intracystic bradyzoïtes in vitro, but long term administration of azithromycin to chronically infected mice failed to reduce the mean number of brain cysts. In models of acute toxoplasmosis, azithromycin was found to have a limited effect on brain infection, whereas parasites were cleared from blood and lungs of infected mice, resulting in a significant protection of treated mice comparatively to untreated controls. When azithromycin is combined with pyrimethamine or sulfadiazine, an additive effect is observed in vitro, and a remarkable synergistic effect is observed in vivo in the treatment of acute toxoplasmosis. Together, these results are in favor of the use of azithromycin in combined therapies for the treatment and/or prophylaxis of toxoplasmosis.
阿奇霉素在体外可抑制刚地弓形虫速殖子的生长，但只有在药物长时间孵育后才能观察到这种效果，这反映了这种大环内酯类药物对寄生虫的作用方式较为迟缓。阿奇霉素可能通过抑制蛋白质合成发挥作用，但尚未证实其在寄生虫中的作用位点和结合部位。阿奇霉素在体外对包囊内的缓殖子也有效，但长期给慢性感染的小鼠施用阿奇霉素未能减少脑包囊的平均数量。在急性弓形虫病模型中，发现阿奇霉素对脑部感染的作用有限，而寄生虫可从感染小鼠的血液和肺部清除，与未治疗的对照组相比，治疗组小鼠得到了显著保护。当阿奇霉素与乙胺嘧啶或磺胺嘧啶联合使用时，在体外观察到相加作用，在体内治疗急性弓形虫病时观察到显著的协同作用。总之，这些结果支持在联合治疗中使用阿奇霉素来治疗和/或预防弓形虫病。
