Atovaquone Plus Cholestyramine Center for Research on Biotoxin-Associated Illnes

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1: Adv Ther. 2006 Jan-Feb;23(1):1-11. Related Articles, Links

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search & DB=pubmed

Atovaquone Plus Cholestyramine in Patients Coinfected With Babesia

microti and Borrelia burgdorferi Refractory to Other Treatment.

Shoemaker RC, Hudnell HK, House DE, Van Kempen A, Pakes GE.

Center for Research on Biotoxin-Associated Illnesses Pocomoke City,

land.

Ten percent of US patients with Lyme disease are coinfected with

Babesia microti. A double-blind, placebo-controlled, crossover trial

enrolled 25 patients with confirmed Borrelia burgdorferi/B microti

coinfection, abnormal visual contrast sensitivity (VCS), and

persistent symptoms despite prior treatment with atovaquone and

azithromycin. Patients were randomly assigned to atovaquone

suspension or placebo plus cholestyramine for 3 weeks, were crossed

over for 3 weeks, and then received open-label atovaquone and

cholestyramine for 6 weeks. Symptoms and VCS scores were recorded at

baseline and after weeks 3, 6, 9, and 12. Improvements in symptoms

and VCS deficits were observed only after at least 9 weeks of

treatment. At week 12, 5 patients were asymptomatic, and 16 had a

notable reduction in the number of symptoms. The entire cohort

demonstrated significant increases in VCS scores. Adverse effects

were rare. Patients coinfected with B burgdorferi and B microti

derive measurable clinical benefit from prolonged treatment with

atovaquone and cholestyramine. Longer-term combination therapy may

be indicated.

PMID: 16644602 [PubMed - in process]