Relapse of Tropheryma whipplei endocarditis treated by trimethoprim/sulfamethoxazole, cured by hydroxychloroquine plus doxycycline

Emonet, Stéphane; Wuillemin, Timothee; Harbarth, Stéphan Juergen; Wassilew, Nasstasja; Çıkırıkçıoğlu, Mustafa; Schrenzel, Jacques; Lagier, Jean-Christophe; Raoult, Didier; Delden, Christian van

doi:10.1016/j.ijid.2014.11.003

Cited by 16 publications

(5 citation statements)

References 21 publications

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“…As anti-infectives, CQ/HCQ have been successfully used to treat bacterial [ 22 , 23 ], and fungal infections [ 24 , 25 , 26 ]. Even though their exact antiviral mechanism of action is still unclear, CQ/HCQ may abrogate viral entry and replication inside host cells by altering endosomal acidification and pH-dependent enzymatic cleavage, by inhibiting post-translational modifications of viral proteins, or by restricting cellular iron accumulation [ 27 , 28 , 29 ].…”

Section: Antimalarial Drugsmentioning

confidence: 99%

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

et al. 2022

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More than two years have passed since the viral outbreak that led to the novel infectious respiratory disease COVID-19, caused by the SARS-CoV-2 coronavirus. Since then, the urgency for effective treatments resulted in unprecedented efforts to develop new vaccines and to accelerate the drug discovery pipeline, mainly through the repurposing of well-known compounds with broad antiviral effects. In particular, antiparasitic drugs historically used against human infections due to protozoa or helminth parasites have entered the main stage as a miracle cure in the fight against SARS-CoV-2. Despite having demonstrated promising anti-SARS-CoV-2 activities in vitro, conflicting results have made their translation into clinical practice more difficult than expected. Since many studies involving antiparasitic drugs are currently under investigation, the window of opportunity might be not closed yet. Here, we will review the (controversial) journey of these old antiparasitic drugs to combat the human infection caused by the novel coronavirus SARS-CoV-2.

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Section: Antimalarial Drugsmentioning

confidence: 99%

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

et al. 2022

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“…As alternative therapy, 2-4 weeks of ceftriaxone (2 g/24 h intravenously) or 2-4 weeks of penicillin G (2 million U/4 h) and streptomycin (1 g/24 h) intravenously can be used, followed by, at least, 1 year of oral trimethoprim/sulfamethoxazole (800 mg/12 h) [74]. It is likely that this recommendation was included after taking into consideration an in vitro T. whipplei resistant to trimethoprim, a case report of a patient with clinically acquired resistance to trimethoprim/sulfamethoxazole and the cases of T. whipplei endocarditis relapses after treatment with trimethoprim/sulfamethoxazole which were apparently cured after two years of doxycycline and hidroxychloroquine [109,114,131,132]. Furthermore, some authors do not recommend the use of trimethoprim/ sulfamethoxazole because the clinical, microbiological and genetic data analyses show that it is an antibiotic not efficient for the management of T. whipplei endocarditis [109].…”

Section: Treatmentmentioning

confidence: 99%

Tropheryma whippleiEndocarditis

García‐Álvarez¹,

Oteo²

2021

Advanced Concepts in Endocarditis - 2021

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Tropheryma whipplei mainly known as the causative agent of classical Whipple’s disease, also produces acute, sub-acute and chronic localized forms of infection such as endocarditis. The development of molecular tools has allowed increasing the number of cases of endocarditis due to blood culture use to be negative in T. whipplei endocarditis and most of the cases are confirmed post-surgery when molecular analyses of heart valves are performed. Although, T. whipplei endocarditis is an uncommon condition with an atypical presentation it must be considered in the diagnosis of blood culture negative endocarditis and in patients with heart failure in which valve affectation is present. Other clinical features such as long lasting arthralgia can be present in a high percentage of the patients. It is important to know that few cases are diagnosed in the context of the classical Whipple’s disease. The prognosis is very good when an appropriate surgical management and antimicrobial-specific treatment is given. This chapter describes the epidemiological, clinical characteristics, diagnosis and treatments for T. whipplei endocarditis.

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“…Cobicistat shows a theoretically better drug-drug interaction profile, due to the more selective 3A4 isoenzyme inhibition, but clinical experience with drugs other than ARVs is lacking. 3,8 A middle-aged male patient with HIV since 1987, treated since the early 1990s with several ARV regimens and experienced multiple virological failures causing an MDR strain (62V/65R/ 101E/181C/184I mutations, conferring resistance to lamivudine/ emtricitabine/didanosine/abacavir/nevirapine/efavirenz/rilpivirine/ etravirine and partial resistance to tenofovir). In 2014 he had an undetectable viral load and CD4 lymphocyte count .1000 cells/mm 3 , and was on 800/100 mg of darunavir/ritonavir once daily and 400 mg of raltegravir twice daily.…”

Section: Transparency Declarationsmentioning

confidence: 99%

“…4 -10 Moreover, the current data support doxycycline in combination with hydroxychloroquine for a bactericidal effect and if allergies preclude sulphonamide therapy. 11 Emonet et al 8 detail a relapse of T. whipplei endocarditis treated with sulfamethoxazole/trimethoprim and cured by hydroxychloroquine plus doxycycline.…”

mentioning

confidence: 99%

Successful treatment with ceftriaxone induction and minocycline maintenance for gastrointestinal Whipple's disease: Table 1.

Derrick

Love

Sanasi-Bhola

2015

J. Antimicrob. Chemother.

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non-penicillinase-producing N. gonorrhoeae and observed that 90% of the strains were susceptible at 0.45 mg/L (range for penicillinase producing ¼ 0.25-32). Jules and Neu 2 also confirmed that temocillin had inhibitory in vitro activity against N. gonorrhoeae at 1 mg/L regardless of the ability to produce penicillinase. The introduction of temocillin in the treatment of N. gonorrhoeae infection would be beneficial as it offers the opportunity for singledose intramuscular treatment due to a half-life of 6 h. In Denmark, the prevalence of ceftriaxone-resistant N. gonorrhoeae is low and it has not been possible to provide a ceftriaxoneresistant N. gonorrhoeae to test temocillin. The treatment options for N. gonorrhoeae are limited due to the increasing resistance to many antibiotics such as sulphonamides, penicillins, cephalosporins, tetracyclines, macrolides and fluoroquinolones. 5 Dual antimicrobial therapy has been introduced in the USA, where ceftriaxone in combination with azithromycin or doxycycline is used. Single-dose monotherapy is still the preferred treatment in most countries. Furthermore, different new drugs are under investigation; for instance, ertapenem and solithromycin have received attention, since both drugs have good in vitro activity against gonorrhoeae isolates, including isolates that showed resistance to third-generation extended-spectrum cephalosporins. 7 In conclusion, due to the lack of new effective antibiotics, revival of old antibiotics is needed. Temocillin will perhaps offer an extra option to cephalosporins in a limited area. Future studies should clarify the role of temocillin in the treatment of gonorrhoea in general and particularly in the treatment of ceftriaxone-resistant N. gonorrhoeae.

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Relapse of Tropheryma whipplei endocarditis treated by trimethoprim/sulfamethoxazole, cured by hydroxychloroquine plus doxycycline

Cited by 16 publications

References 21 publications

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

Tropheryma whippleiEndocarditis

Successful treatment with ceftriaxone induction and minocycline maintenance for gastrointestinal Whipple's disease: Table 1.

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