Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1994 Aug;38(8):1803–1807. doi: 10.1128/aac.38.8.1803

Activity of epiroprim (Ro 11-8958), a dihydrofolate reductase inhibitor, alone and in combination with dapsone against Toxoplasma gondii.

H R Chang 1, D Arsenijevic 1, R Comte 1, A Polak 1, R L Then 1, J C Pechère 1
PMCID: PMC284639  PMID: 7986011

Abstract

We examined the effect of epiroprim (Ro 11-8958), a dihydrofolate reductase inhibitor, alone and in combination with dapsone, against Toxoplasma gondii. In vitro, the anti-T. gondii effects of epiroprim and dapsone were observed at nanogram-per-milliliter levels when a 72-h uracil assay and an infection rate of one parasite per 120 macrophages were used. In combination, these drugs exerted a synergistic effect that, however, was only parasitostatic. In a model of acute infection, mice were infected intraperitoneally with 10(4) parasites of the RH strain of T. gondii and were treated for 14 days by gavage (therapy divided into two daily dosages), starting 24 h after infection. Used alone, dapsone and epiroprim, each at a dose of 50 mg/kg of body weight per day, protected 10 and 0% of the mice, respectively. When these drugs were administered simultaneously, a 100% survival rate was observed. Pyrimethamine-sulfadiazine (4 and 250 mg/kg/day, respectively) protected 100% of the mice. A 3-week therapy of chronically infected mice with either epiroprim (50 mg/kg/day), dapsone (50 mg/kg/day), or pyrimethamine (15 mg/kg/day) reduced the numbers of T. gondii cysts and the inflammation in their brains. A combination of epiroprim and dapsone, both at 50 mg/kg/day, further reduced the number of brain cysts in comparison with the number after the corresponding monotherapies. Epiroprim may have a role in the prophylaxis or therapy of human toxoplasmosis, especially when combined with other drugs active against T. gondii, such as dapsone.

Full text

PDF
1803

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Araujo F. G., Guptill D. R., Remington J. S. Azithromycin, a macrolide antibiotic with potent activity against Toxoplasma gondii. Antimicrob Agents Chemother. 1988 May;32(5):755–757. doi: 10.1128/aac.32.5.755. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Araujo F. G., Huskinson J., Remington J. S. Remarkable in vitro and in vivo activities of the hydroxynaphthoquinone 566C80 against tachyzoites and tissue cysts of Toxoplasma gondii. Antimicrob Agents Chemother. 1991 Feb;35(2):293–299. doi: 10.1128/aac.35.2.293. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chang H. R., Comte R., Pechère J. C. In vitro and in vivo effects of doxycycline on Toxoplasma gondii. Antimicrob Agents Chemother. 1990 May;34(5):775–780. doi: 10.1128/aac.34.5.775. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Chang H. R., Comte R., Piguet P. F., Pechère J. C. Activity of minocycline against Toxoplasma gondii infection in mice. J Antimicrob Chemother. 1991 May;27(5):639–645. doi: 10.1093/jac/27.5.639. [DOI] [PubMed] [Google Scholar]
  5. Chang H. R., Jefford C. W., Pechère J. C. In vitro effects of three new 1,2,4-trioxanes (pentatroxane, thiahexatroxane, and hexatroxanone) on Toxoplasma gondii. Antimicrob Agents Chemother. 1989 Oct;33(10):1748–1752. doi: 10.1128/aac.33.10.1748. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chang H. R., Pechere J. C. Effect of roxithromycin on acute toxoplasmosis in mice. Antimicrob Agents Chemother. 1987 Jul;31(7):1147–1149. doi: 10.1128/aac.31.7.1147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Chang H. R., Rudareanu F. C., Pechère J. C. Activity of A-56268 (TE-031), a new macrolide, against Toxoplasma gondii in mice. J Antimicrob Chemother. 1988 Sep;22(3):359–361. doi: 10.1093/jac/22.3.359. [DOI] [PubMed] [Google Scholar]
  8. Dannemann B., McCutchan J. A., Israelski D., Antoniskis D., Leport C., Luft B., Nussbaum J., Clumeck N., Morlat P., Chiu J. Treatment of toxoplasmic encephalitis in patients with AIDS. A randomized trial comparing pyrimethamine plus clindamycin to pyrimethamine plus sulfadiazine. The California Collaborative Treatment Group. Ann Intern Med. 1992 Jan 1;116(1):33–43. doi: 10.7326/0003-4819-116-1-33. [DOI] [PubMed] [Google Scholar]
  9. Derouin F., Chastang C. In vitro effects of folate inhibitors on Toxoplasma gondii. Antimicrob Agents Chemother. 1989 Oct;33(10):1753–1759. doi: 10.1128/aac.33.10.1753. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. FRENKEL J. K., WEBER R. W., LUNDE M. N. Acute toxoplasmosis. Effective treatment with pyrimethamine, sulfadiazine, leucovorin calcium, and yeast. JAMA. 1960 Jul 30;173:1471–1476. doi: 10.1001/jama.1960.03020310059017. [DOI] [PubMed] [Google Scholar]
  11. Fernandez-Martin J., Leport C., Morlat P., Meyohas M. C., Chauvin J. P., Vilde J. L. Pyrimethamine-clarithromycin combination for therapy of acute Toxoplasma encephalitis in patients with AIDS. Antimicrob Agents Chemother. 1991 Oct;35(10):2049–2052. doi: 10.1128/aac.35.10.2049. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Girard P. M., Landman R., Gaudebout C., Olivares R., Saimot A. G., Jelazko P., Gaudebout C., Certain A., Boué F., Bouvet E. Dapsone-pyrimethamine compared with aerosolized pentamidine as primary prophylaxis against Pneumocystis carinii pneumonia and toxoplasmosis in HIV infection. The PRIO Study Group. N Engl J Med. 1993 May 27;328(21):1514–1520. doi: 10.1056/NEJM199305273282102. [DOI] [PubMed] [Google Scholar]
  13. Kovacs J. A. Efficacy of atovaquone in treatment of toxoplasmosis in patients with AIDS. The NIAID-Clinical Center Intramural AIDS Program. Lancet. 1992 Sep 12;340(8820):637–638. doi: 10.1016/0140-6736(92)92172-c. [DOI] [PubMed] [Google Scholar]
  14. Leport C., Raffi F., Matheron S., Katlama C., Regnier B., Saimot A. G., Marche C., Vedrenne C., Vilde J. L. Treatment of central nervous system toxoplasmosis with pyrimethamine/sulfadiazine combination in 35 patients with the acquired immunodeficiency syndrome. Efficacy of long-term continuous therapy. Am J Med. 1988 Jan;84(1):94–100. doi: 10.1016/0002-9343(88)90014-9. [DOI] [PubMed] [Google Scholar]
  15. Luft B. J., Remington J. S. AIDS commentary. Toxoplasmic encephalitis. J Infect Dis. 1988 Jan;157(1):1–6. doi: 10.1093/infdis/157.1.1. [DOI] [PubMed] [Google Scholar]
  16. Luft B. J., Remington J. S. Toxoplasmic encephalitis in AIDS. Clin Infect Dis. 1992 Aug;15(2):211–222. doi: 10.1093/clinids/15.2.211. [DOI] [PubMed] [Google Scholar]
  17. Medina I., Mills J., Leoung G., Hopewell P. C., Lee B., Modin G., Benowitz N., Wofsy C. B. Oral therapy for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. A controlled trial of trimethoprim-sulfamethoxazole versus trimethoprim-dapsone. N Engl J Med. 1990 Sep 20;323(12):776–782. doi: 10.1056/NEJM199009203231202. [DOI] [PubMed] [Google Scholar]
  18. Pfefferkorn E. R., Borotz S. E., Nothnagel R. F. Toxoplasma gondii: characterization of a mutant resistant to sulfonamides. Exp Parasitol. 1992 May;74(3):261–270. doi: 10.1016/0014-4894(92)90149-5. [DOI] [PubMed] [Google Scholar]
  19. Pfefferkorn E. R., Nothnagel R. F., Borotz S. E. Parasiticidal effect of clindamycin on Toxoplasma gondii grown in cultured cells and selection of a drug-resistant mutant. Antimicrob Agents Chemother. 1992 May;36(5):1091–1096. doi: 10.1128/aac.36.5.1091. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Pfefferkorn E. R., Pfefferkorn L. C. Specific labeling of intracellular Toxoplasma gondii with uracil. J Protozool. 1977 Aug;24(3):449–453. doi: 10.1111/j.1550-7408.1977.tb04774.x. [DOI] [PubMed] [Google Scholar]
  21. Then R. L., Böhni E., Angehrn P., Plozza-Nottebrock H., Stoeckel K. New analogs of trimethoprim. Rev Infect Dis. 1982 Mar-Apr;4(2):372–377. doi: 10.1093/clinids/4.2.372. [DOI] [PubMed] [Google Scholar]
  22. Walzer P. D., Foy J., Steele P., White M. Synergistic combinations of Ro 11-8958 and other dihydrofolate reductase inhibitors with sulfamethoxazole and dapsone for therapy of experimental pneumocystosis. Antimicrob Agents Chemother. 1993 Jul;37(7):1436–1443. doi: 10.1128/aac.37.7.1436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Weidekamm E., Plozza-Nottebrock H., Forgo I., Dubach U. C. Plasma concentrations in pyrimethamine and sulfadoxine and evaluation of pharmacokinetic data by computerized curve fitting. Bull World Health Organ. 1982;60(1):115–122. [PMC free article] [PubMed] [Google Scholar]
  24. Zuidema J., Hilbers-Modderman E. S., Merkus F. W. Clinical pharmacokinetics of dapsone. Clin Pharmacokinet. 1986 Jul-Aug;11(4):299–315. doi: 10.2165/00003088-198611040-00003. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES