PMID: 16644602Apr 29, 2006Paper

Atovaquone plus cholestyramine in patients coinfected with Babesia microti and Borrelia burgdorferi refractory to other treatment

Advances in Therapy
Ritchie C ShoemakerCOL40155 Study Team

Abstract

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.

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Citations

Apr 9, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Paul M LantosGary P Wormser
Jul 23, 2011·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Leonard H Sigal
Dec 31, 2019·PloS One·Kaitlin M YoungLisa A Waddell
May 19, 2021·Translational Vision Science & Technology·Alison W RebmanSheila K West

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