Wittner M, Lederman J, Tanowitz H B, Rosenbaum G S, Weiss L M
Department of Pathology (Division of Parasitology), Albert Einstein College of Medicine, Bronx, New York, Southampton Hospital, Southampton, New York, USA.
Am J Trop Med Hyg. 1996 Aug;55(2):219-22. doi: 10.4269/ajtmh.1996.55.219.
The traditional therapy for the treatment of human Babesia microti infections has been the combination of clindamycin and quinine. However, in recent years, it has become apparent that some patients have not responded to this regimen. We became involved in the treatment of several cases of babesiosis in which atovaquone was used to treat this infection. Therefore, using the hamster model, we determined the efficacy of atovaquone alone as well as atovaquone plus azithromycin for the treatment of experimental babesiosis. Atovaquone (100 mg/kg/day) and atovaquone (100 mg/kg/day) with azithromycin (150 mg/kg/day) were effective agents for the treatment of experimental babesiosis in hamsters. When atovaquone was used as monotherapy recrudescences occurred. Organisms obtained from recrudescent animals, when inoculated into uninfected animals, proved to be unresponsive to atovaquone therapy, suggesting the emergence of drug resistance. Resistant organisms did not emerge in hamsters treated with the combination of atovaquone and azithromycin. Atovaquone should be considered in the therapeutic regimen of patients with babesiosis who have either failed standard therapy or have become intolerant to such therapy.
治疗人类微小巴贝斯虫感染的传统疗法是克林霉素和奎宁联合使用。然而，近年来，一些患者对该治疗方案无反应的情况变得明显。我们参与了几例巴贝斯虫病的治疗，其中使用阿托伐醌治疗这种感染。因此，我们利用仓鼠模型确定了单独使用阿托伐醌以及阿托伐醌加阿奇霉素治疗实验性巴贝斯虫病的疗效。阿托伐醌（100毫克/千克/天）以及阿托伐醌（100毫克/千克/天）与阿奇霉素（150毫克/千克/天）联合使用是治疗仓鼠实验性巴贝斯虫病的有效药物。当单独使用阿托伐醌进行治疗时会出现复发情况。从复发动物身上获取的病原体接种到未感染动物体内后，被证明对阿托伐醌治疗无反应，这表明出现了耐药性。在使用阿托伐醌和阿奇霉素联合治疗的仓鼠中未出现耐药病原体。对于标准治疗失败或对该治疗不耐受的巴贝斯虫病患者，在治疗方案中应考虑使用阿托伐醌。
