Parasite therapy

Abstract

There is disclosed herein a composition for treating extracellular parasitic infections, the composition comprising one or more of the following combinations: at least one quinolone or fluoroquinolone together with at least one tetracycline, iodoquinol, an azole or imidazole; or at least two agents selected from the group consisting of iodoquinol, thiazolidones, tetracycline, nitroimidazoles, cotrimoxazole and diloxanide furoate. There is also disclosed herein a method for treating extracellular parasitic infections in a vertebrate in need of said treatment, wherein said treatment comprises administering to said vertebrate a therapeutically effective amount of (i) a composition comprising a quinolone or fluoroquinolone together with a pharmaceutically acceptable carrier or (ii) a composition of the invention or (iii) a combination of at least one quinolone or fluoroquinolone optionally together with at least one tetracycline, is iodoquinol, an azole or imidazole; or (iv) a combination of at least two agents selected from the group consisting of iodoquinol, thiazolidones, tetracycline, nitroimidazoles, cotrimoxazole and diloxanide furoate.

Claims

1. A composition for treating extracellular parasitic infections, the composition comprising: (a) a combination of drugs comprising diloxanide furoate, doxycycline and metronidazole; b) a combination of drugs comprising secnidazole, diloxanide furoate and cotrimoxazole, or (c) a combination of drugs comprising cotrimoxazole, diloxanide furoate, secnidazole and doxycycline.

2. The composition of claim 1, further comprising an additional anti-parasitic drug.

3. The composition of claim 2, wherein the additional anti-parasitic drug is selected from any of emetine, quinacrine, satranidazole, flunidazole, ronidazole and mixtures thereof.

4. The composition of claim 1, wherein the combination of drugs comprises diloxanide furoate, doxycycline and metronidazole.

5. The composition of claim 1, wherein comprising the combination of drugs comprises secnidazole, diloxanide furoate and cotrimoxazole.

6. The composition of claim 1, wherein the combination of drugs comprises cotrimoxazole, diloxanide furoate, secnidazole and doxycycline.

7. The composition of claim 1, further comprising tetracycline.

8. The composition of claim 1, further comprising iodoquinol.

9. The composition of claim 1, further comprising an azole.

10. The composition of claim 1, further comprising an imidazole.

11. A method for treating extracellular parasitic infections in a vertebrate individual in need of said treatment, wherein said treatment comprises administering to said vertebrate individual a therapeutically effective amount of: a composition of claim 1.

12. The method of claim 11 wherein the extracellular parasite is Blastocystis hominis, Dientamoeba fragilis or both Blastocystis hominis and Dientamoeba fragilis.

13. The method of claim 11, wherein the administering comprises administering a dosage of at least one milligram to five grams per day to the vertebrate individual in need thereof.

14. The method of claim 11, further comprising administering to said vertebrate individual in need thereof at least one tetracycline, iodoquinol, an azole or imidazole.

15. The method of claim 11, wherein the combination comprises diloxanide furoate, doxycycline and metronidazole.

16. The method of claim 11, wherein the combination comprises secnidazole, diloxanide furoate and cotrimoxazole.

17. The method of claim 11, wherein the vertebrate individual in need of said treatment is a human.

Description

EXAMPLE 1

(1) A 27 year old female with recurrent IBS-type symptoms characterized by diarrhoea, bloating, flatulence and cramping right iliac fossa pain was colonoscoped and found to have no abnormalities. However on aspiration of colonic fluid during the colonoscopy she was found to have B. hominis infection. She was treated with a combination of norfloxacin and ketoconazole. Four weeks after the cessation of the ten day course she continued to be asymptomatic up to four weeks later when a stool test was carried out and beyond. She was found to be cured of B. hominis and continued to remain well at 6 months follow up.

EXAMPLE 2

(2) A 16 year old male with intermittent diarrhoea, cramping, abdominal pain and pruritus was found to have D. fragilis on stool testing after numerous investigations and visits to the Psychiatrist for treatment of what was diagnosed as anxiety driven IBS. Stool tests found him to be positive for B. hominis and he was treated with 400 mg bid of norfloxacin for 14 days. His symptoms abated by about the 20th day and on follow up at 4 weeks he was negative for B. hominis. He was negative for B. hominis again at 6 months and he was still asymptomatic with negative stool testing.

EXAMPLE 3

(3) A patient was referred after 3 different treatments with metronidazole and tinidazole for a combined B. hominis infection and D. fragilis infection. Given the previous failed therapies she was given a combination of nitazoxanide, furazolidone, and secnidazole. Her symptoms started abating by week 2. By week 4 her stool tests were normal and her symptoms were virtually gone. It took some time for her symptoms completely to abate but she did not completely lose her pruritus ani. Nevertheless, the D. fragilis and B. hominis were absent on 4 week and 8 week stool tests.

EXAMPLE 4

(4) A 47 year old patient was referred following various treatments with metronidazole, furazolidone and nitazoxanide for a combination of B. hominis and D. fragilis. Each time the patient was treated the symptoms improved but then they recurred and the stool examination again showed ongoing B. hominis and D. fragilis. The patient was brought into the clinic and after bowel preparation a transcolonoscopic infusion of furazolidone, nitazoxanide and secnidazole was carried out. Four weeks later the patient stool tests were negative and the symptoms had abated.

EXAMPLE 5

(5) The patient had previously been treated for resistant B. hominis with combination therapies but continued to have stool test positive with symptoms of flatulence, pruritus ani and abdominal distension continued. The patient was treated with secnidazole 400 mg three times a day, diloxanide furoate 500 mg three times per day and Septrin (cotrimoxazole) double strength DS one tablet twice daily for 10 days. The patient's symptoms progressively abated and the stool tests became negative.

EXAMPLE 6

(6) A 67 year old patient with weight loss and diarrhea presented for an endoscopy. No abnormal findings were found but on histology chronic Giardiasis was found. He was treated by his physician previously on speculative treatment with metronidazole in adequate doses yet the diarrhea did not settle and the patient continued to have Giardia lamblia infection found histologically at endoscopy. The patient was treated with metronidazole 400 mg two times a day, together with nitazoxanide 500 mg two times a day and furazolidone 100 mg three times a day and was able to be cleared of infection when next followed up with stool tests. His diarrhea settled.

EXAMPLE 7

(7) The patient had previously failed three drugs combination for treatment of B. hominis and D. fragilis. The patient was referred to the Clinic for treatment. Symptoms were quite severe and he was given a combination of four medications including Septrin DS (cotrimoxazole) two times a day, diloxanide furoate 500 mg three times a day and secnidazole 400 mg three times a day together with doxycycline 50 mg two times a day. His symptoms resolved in about three weeks although there were quite some major adverse effects with nausea and malaise progressively the patient's symptoms improved two to three months later.

EXAMPLE 8

(8) The patient had quite resistant Blastocystis hominis infection and was referred for further treatment following multiple metronidazole failed therapies. He was treated with a rescue therapy containing nitazoxanide 500 mg two times a day, furazolidone 100 mg three times a day, secnidazole 400 mg three times a day and doxycycline 50 mg twice a day for ten days. His symptoms progressively resolved and he was free of the infection on stool test carried out on several occasions at 4 and 6 weeks.

(9) Although the invention has been described with reference to specific examples, it will be appreciated to those skilled in the art that the invention may be embodiment in many other forms.