Jd. Utzinger et al., Effect of combined treatment with praziquantel and artemether on Schistosoma japonicum and Schistosoma mansoni in experimentally infected animals, ACT TROP, 80(1), 2001, pp. 9-18
Praziquantel and artemether are safe and efficacious antischistosomal drugs
that act against different developmental stages of the parasite: praziquan
tel against adult worms and artemether against schistosomula. A combined tr
eatment has been suggested as a strategy for transmission control. Recent l
aboratory experiments with rabbits with a mixed infection of Schistosoma ja
ponicum parasites of different ages confirmed the effectiveness of a combin
ation therapy. In the present work. we assessed the effect of a combined tr
eatment on adult worms of S. japonicum and found significantly higher worm
reduction rates than with a single dose of praziquantel. In a next step, we
extended the study of the combined treatment to Schistosoma mansoni. A com
bined treatment with 75 mg/kg praziquantel and 150 mg/kg artemether was adm
inistered to hamsters infected with juvenile and adult S. mansoni. The two
drugs, administered simultaneously or spaced by 6 h, 1, 3 or 7 days, result
ed in significantly higher worm reduction rates than a single treatment wit
h praziquantel. A combination therapy with increased doses of 100 mg/kg pra
ziquantel and 300 mg/kg artemether showed very high worm reduction rates of
90% and above, however, some hamsters died in five different combined trea
tment experiments, suggesting that these drug concentrations were too high.
We conclude that a combined treatment with praziquantel and artemether at
the lower doses is safe and more effective than praziquantel alone, which f
orms a foundation for designing respective clinical trials in humans. (C) 2
001 Elsevier Science B.V. All rights reserved.