Antibiotics versus no treatment for toxoplasma retinochoroiditis

Pradhan, Eli; Bhandari, S.; Gilbert, Ruth; Stanford, Miles

doi:10.1002/14651858.cd002218.pub2

Cited by 33 publications

(56 citation statements)

References 27 publications

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“…A 2011 report by the American Academy of Ophthalmology concluded that there is no level I evidence to support the routine use of antimicrobials in acute OT treatment in immunocompetent patients (137). A recent Cochrane review of randomized trials of antimicrobial treatment versus placebo or no treatment also did not find evidence supporting visual acuity improvement with treatment (138). Nonetheless, many uveitis experts treat lesions that are vision threatening or have significant inflammation because of fear of vision loss (136).…”

Section: Ocular Toxoplasmosismentioning

confidence: 99%

Treatment of Toxoplasmosis: Historical Perspective, Animal Models, and Current Clinical Practice

et al. 2018

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SUMMARYPrimary infection is usually subclinical, but cervical lymphadenopathy or ocular disease can be present in some patients. Active infection is characterized by tachyzoites, while tissue cysts characterize latent disease. Infection in the fetus and in immunocompromised patients can cause devastating disease. The combination of pyrimethamine and sulfadiazine (pyr-sulf), targeting the active stage of the infection, is the current gold standard for treating toxoplasmosis, but failure rates remain significant. Although other regimens are available, including pyrimethamine in combination with clindamycin, atovaquone, clarithromycin, or azithromycin or monotherapy with trimethoprim-sulfamethoxazole (TMP-SMX) or atovaquone, none have been found to be superior to pyr-sulf, and no regimen is active against the latent stage of the infection. Furthermore, the efficacy of these regimens against ocular disease remains uncertain. In multiple studies, systematic screening for infection during gestation, followed by treatment with spiramycin for acute maternal infections and with pyr-sulf for those with established fetal infection, has been shown to be effective at preventing vertical transmission and minimizing the severity of congenital toxoplasmosis (CT). Despite significant progress in treating human disease, there is a strong impetus to develop novel therapeutics for both the acute and latent forms of the infection. Here we present an overview of toxoplasmosis treatment in humans and in animal models. Additional research is needed to identify novel drugs by use of innovative high-throughput screening technologies and to improve experimental models to reflect human disease. Such advances will pave the way for lead candidates to be tested in thoroughly designed clinical trials in defined patient populations.

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Section: Ocular Toxoplasmosismentioning

confidence: 99%

Treatment of Toxoplasmosis: Historical Perspective, Animal Models, and Current Clinical Practice

et al. 2018

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“…In immune competent individuals the most widely accepted regimen involves the use of the folic acid antagonist pyrimethamine with or without added sulfadizine with the main application being the treatment of Toxoplasma associated eye disease (Pradhan et al 2016). In addition to having toxicities related to its mechanism of action as noted above, this mechanism is generally ineffective against the bradyzoite form of the organism and thus cannot be used to treat tissue cysts, the form of the organism resident in the central nervous system of immune competent individuals.…”

Section: Current Status Of Anti-toxoplasma Medicationsmentioning

confidence: 99%

Toxoplasma gondii—A Gastrointestinal Pathogen Associated with Human Brain Diseases

Severance¹,

Xiao²,

Jones‐Brando³

et al. 2016

International Review of Neurobiology

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“…Sin embargo, existe aun controversia en relación a la combinación de varias drogas, el uso de tratamiento sistémico versus intravítreo y la utilización de esteroides. De acuerdo con la última revisión Cochrane, el tratamiento de la corioretinitis por toxoplasmosis podría disminuir el (3,(16)(17)(18) riesgo de recurrencia . Especial cuidado debe tenerse en pacientes inmunocomprometidos, con l e s i o n e s a c t i va s d e l a c á m a r a p o s t e r i o r , considerando que pueden presentar formas (19) fulminantes de TO .…”

Section: Discussionunclassified

Toxoplasmosis ocular: Frecuencia y características clínicas en un consultorio de oftalmología pediátrica.

Cardozo¹,

Mesquita²,

Godoy³

2019

Pediatr (Asunción).

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Introducción: La toxoplasmosis afecta frecuentemente la cámara posterior del ojo y puede producir pérdida de la visión. Objetivo: Describir la frecuencia y características clínicas de la Toxoplasmosis ocular en un consultorio de oftalmología pediátrica. Materiales y Métodos: Estudio observacional, descriptivo retrospectivo Se analizaron las historias clínicas de pacientes de 0 a 18 años de edad, con toxoplasmosis ocular, atendidos en el consultorio de oftalmología pediátrica, desde enero 2011 a mayo de 2014. Variables: edad, sexo, forma de toxoplasmosis, tipo de lesión ocular, localización de la lesión, compromiso unilateral o bilateral, y complicaciones oculares. Los datos se analizaron con SPSSv21 utilizando estadísticas descriptivas e inferenciales. No fue necesario el consentimiento informado porque se trata de un estudio retrospectivo. Resultados: Ingresaron 72 pacientes. La mediana de edad 48 meses, fueron neonatos el 6,9%. El 52,8% eran sexo femenino. El 80,5% presentaron toxoplasmosis adquirida y el 19, 4% congénita. Todos los pacientes tenían coriorretinitis. Y en el 7% se acompañaron de uveítis. La afectación fue bilateral en 52.8%. Las lesiones eran inactivas en 87,5 con localización central. Presentaron complicaciones en el 58,3% de los pacientes: estrabismo en 76% y en 24 % desprendimiento de retina. Conclusión: La frecuencia de TO fue del 0,8%. La mayoría de los pacientes tenían más de 2 años de edad y el 19% tenía toxoplasmosis congénita. Todos tuvieron corioretinitis, con compromiso bilateral y localización central más frecuentemente. Hubo predominio de lesiones inactivas tanto en la toxoplasmosis congénita como en la adquirida. Las complicaciones fueron estrabismo y desprendimiento de retina. Correspondencia: Mirta Mesquita Correo: mirtanmr@gmail.com Conflicto de interés: Los autores declaran no poseer conflicto de interés Recibido: 21/10/2018; Aceptado: 28/12/2018

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Antibiotics versus no treatment for toxoplasma retinochoroiditis

Cited by 33 publications

References 27 publications

Treatment of Toxoplasmosis: Historical Perspective, Animal Models, and Current Clinical Practice

Treatment of Toxoplasmosis: Historical Perspective, Animal Models, and Current Clinical Practice

Toxoplasma gondii—A Gastrointestinal Pathogen Associated with Human Brain Diseases

Toxoplasmosis ocular: Frecuencia y características clínicas en un consultorio de oftalmología pediátrica.

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