Which medications in the drug class Antiprotozoal agents are used in the treatment of Chagas Disease (American Trypanosomiasis)?

Updated: Apr 26, 2019
  • Author: Louis V Kirchhoff, MD, MPH; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Antiprotozoal agents

These agents are used to treat infections caused by the protozoan T cruzi.

Benznidazole

Nitroimidazole antimicrobial. Generates radical species in both aerobic and anaerobic conditions that are capable of damaging parasitic DNA. Inhibits DNA, RNA, and protein synthesis within the T cruzi parasite. Studies suggest benznidazole is reduced by a type I nitroreductase (NTR) enzyme of T cruzi, producing a series of short-lived intermediates that may promote damage to several macromolecules, including DNA. Approved by the FDA for treatment of Chagas disease in children aged 2-12 years. The CDC recommends antiparasitic treatment for all cases of acute (ie, congenital) or reactivated Chagas disease and for chronic T cruzi in children up to age 18 years. The CDC also strongly recommends treatment for adults aged 50 years or younger with chronic infection who do not already have advanced Chagas cardiomyopathy.

Nifurtimox (Lampit, Bayer 2502)

Available only from the CDC Drug Service (Ph. 404‑639‑3670). Well absorbed by digestive tract. Trypanocidal drug that acts on circulating trypomastigotes, as well as intracellular amastigotes. The mechanism of action may depend on the formation of nitro anion radicals, but precise details are not known. Efficacy can be assessed by monitoring disappearance of T cruzi–specific antibodies, although this may take several years in some patients. Repeated PCR assay can be used to look for treatment failure.


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