• Journal of Veterinary Clinics
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• v.33 no.1
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• pp.16-20
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• 2016

This study was performed to estimate the clinical use of combination therapy with atovaquone/proguanil and azithromycin as a effective treatment in dogs infected with Babesia gibsoni. Eight mixed-breed dogs that were infected naturally with B. gibsoni were used in this study. Four dogs (No. 1-4) as experimental group received atovaquone/proguanil and azithromycin therapy. As for the other four dogs as the control group (No. 5-8) were administered diminazene aceturate and tetracycline/clindamycin. All the dogs in this study showed mild to severe anemia and thrombocytopenia. After initiating the treatment B. gibsoni in blood smears disappeared. PCR analysis of the experimental group showed negative results during the observation period, but more than one dog from the control groups showed continuous positive results. Atovaquone/proguanil and azithromycin combination therapy can significantly lower the B. gibsoni parasitemia levels and the results suggested that this combination therapy should be a new protocol for an effective treatment in dogs infected with B. gibsoni.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.2
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• pp.494-498
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• 2009

The emergence and spread of drug-resistant malaria parasites is a serious public health problem in the tropical world. Useful antimalarial drugs such as chloroquine have resistance in the world now. Moreover, other antimalarialdrugs such as mefloquine, halofantrine, atovaquone, proguanil, artemether and lumefantrine retain efficacy but have limitations, one of which is their high cost. New antimalarial drugs are clearly needed now. Cytotoxicity assay and susceptibility assay were performed for the selectivity of herb extracts in vitro. On the basis of high selectivity, 4-day suppressive test and survival test were progressed in Plasmodium berghei-infected mice. The selectivity of Areca catechu L. (ACL) and butanol extract of ACL (ACL-BuOH extract) were 3.4 and 3.0 in vitro, respectively. Moreover in vivo, 4-day suppressive test showed 39.1 % inhibition effect after treated with 150 mg/kg/day ACL-BuOH to P. berghei-infected mice. Survival test also showed 60% survival rate with ACL-BuOH-treated group while all other group mice died. In this study, ACL and ACL-BuOH were investigated for antimalarial activity in vitro and in vivo and they showed a potent antimalarial activity. In particular,ACL-BuOH could specifically lead higher survival rate of mice in vivo. Therefore ACL-BuOH would be a candidate of antimalarial drugs.

• Parasites, Hosts and Diseases
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• v.52 no.6
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• pp.667-672
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• 2014

While imported falciparum malaria has been increasingly reported in recent years in Korea, clinicians have difficulties in making a clinical diagnosis as well as in having accessibility to effective anti-malarial agents. Here we describe an unusual case of imported falciparum malaria with severe hemolytic anemia lasting over 2 weeks, clinically mimicking a coinfection with babesiosis. A 48-year old Korean man was diagnosed with severe falciparum malaria in France after traveling to the Republic of Benin, West Africa. He received a 1-day course of intravenous artesunate and a 7-day course of Malarone (atovaquone/proguanil) with supportive hemodialysis. Coming back to Korea 5 days after discharge, he was readmitted due to recurrent fever, and further treated with Malarone for 3 days. Both the peripheral blood smears and PCR test were positive for Plasmodium falciparum. However, he had prolonged severe hemolytic anemia (Hb 5.6 g/dl). Therefore, 10 days after the hospitalization, Babesia was considered to be potentially coinfected. A 7-day course of Malarone and azithromycin was empirically started. He became afebrile within 3 days of this babesiosis treatment, and hemolytic anemia profiles began to improve at the completion of the treatment. He has remained stable since his discharge. Unexpectedly, the PCR assays failed to detect DNA of Babesia spp. from blood. In addition, during the retrospective review of the case, the artesunate-induced delayed hemolytic anemia was considered as an alternative cause of the unexplained hemolytic anemia.