Treatment of Chagas' disease with itraconazole: electrocardiographic and parasitological conditions after 20 years of follow-up

Abstract

Itraconazole is useful in the treatment of chronic Chagas' disease as it prevented the development of ECG abnormalities and cured 32.6% of patients.

Commiphora leptophloeos Phytochemical and Antimicrobial Characterization

“…The bacterial strains were cultured at 37°C for 18 hours in Mueller-Hinton Broth and the fungal cultures maintained in Sabouraud Dextrose Agar medium and incubated at 35°C for 24 h. As to the preparation of the inoculum, the pricked out strains were transferred to the sterile saline solution (0.9% NaCl), composed of a bacterial/fungal suspension (inoculum) until obtaining the concentration of 10 6 UFC/mL according to the scale of McFarland. The susceptibility tests were performed by Mueller Hinton agar-well diffusion method (Davis and Stout, 1971; Hombach et al, 2013). …”

“…The MIC and MMC were determined for plant extracts that showed antimicrobial activity, by a broth microdilution method (Weinstein et al, 2012; Hombach et al, 2013). Briefly, 100 μL of Mueller–Hinton Broth plus different concentrations of plant extracts were prepared and transferred to each microplate well to obtain dilutions of the active extract, ranging from 0.001 to 100 mg/mL.…”

“…Colonies with macroscopic characteristics of antimicrobial susceptibility patterns from isolates were determined according to Kirby Bauer disk diffusion technique as described by CLSI (Hombach et al, 2013) and Minimum Inhibitory Concentration (MIC). The following three antibiotics were used to determine the antibiogram of the isolates: Tobramycin (10 μg), Vancomycin (30 μg), and Cefoxitin (30 μg).…”

“…The following three antibiotics were used to determine the antibiogram of the isolates: Tobramycin (10 μg), Vancomycin (30 μg), and Cefoxitin (30 μg). Detection of methicillin resistant S. aureus (MRSA) was carried out using cefoxitin (30 μg), an inhibition zone diameter of ≤21 mm was reported as methicillin/oxacillin resistant and ≥22 mm was considered as methicillin/oxacillin sensitive (Hombach et al, 2013; CLSI, 2014; Rabelo et al, 2014). …”

Design or screening of drugs for the treatment of Chagas disease: what shows the most promise?

“…Treatment of humans with chronic Chagas disease with itraconazole produced parasitological cure in 53% and normalization of electrocardiogram (ECG) in 48% of patients (four years follow-up period) [55]. Further, at 20 years’ follow-up, 54.3% of the patients were negative in all the parasitological tests used, and 60% of these cases had normal ECG traces [56]. Fluconazole did not cure mice upon treatment with the 200 mg/kg daily dosage for 30 days [57], which in fact is in agreement with its relatively weak inhibitory potency as T. cruzi CYP51 inhibitor in vitro [58,59].…”