THE POTENTIAL ROLE OF AZITHROMYCIN IN THE TREATMENT OR PROPHYLAXIS OFTOXOPLASMOSIS

Infection with Toxoplasma gondii is the most common parasitic infectio n worldwide with an estimated prevalence of 1-2 billion people. The ri sk of developing severe toxoplasmosis is higher for immunocompromised individuals and fetuses of mothers who have acquired a prime-infection . The current therapy of choice for toxoplasmosis is the synergistic c ombination of pyrimethamine and sulphadiazine. This therapy is highly effective but its use is complicated in immuno-compromised individuals due to adverse secondary effects. Ln addition, since pyrimethamine is potentially teratogenic, its use is not recommended during early preg nancy. Clindamycin, a lincosaminide, in combination with pyrimethamine has been shown to be an acceptable therapeutic alternative in patient s who are unable to tolerate pyrimethamine plus sulphadiazine. In the search for new, effective compounds with less adverse or toxic effects , recent efforts have focused on the new macrolides and the azalides. Here, the results of the investigations and, in particular, the theore tical considerations for the potential use of azithromycin in the ther apy of toxoplasmosis in immunocompromised individuals are reviewed.