Effect of nitazoxanide and spiramycin metronidazole combination in acute experimental toxoplasmosis

Successful treatment of Toxoplasma gondii infection is difficult to attain. This study was designed to evaluate the efficacy of sulfamethoxazole-trimethoprim (SMZ-TMP), as the reference drug, nitazoxanide (NTZ), spiramycin (SP) and SP-metronidazole against the virulent RH T. gondii strain in acute experimental toxoplasmosis. One hundred Swiss albino mice were divided into control and experimental groups. Each mouse was infected with 2500 tachyzoites. Twenty infected untreated mice were used as control. The experimental group was subdivided into four subgroups (20 mice each); IIa SMZ-TMP, IIb NTZ, IIc SP and IId SP-metronidazole. All drugs were in tablet form, and were administered orally in suspension, for a period of seven days. Assessment of each drug efficacy was achieved through the study of mice survival time, mortality rate, parasite load, viability and morphological studies of tachyzoites by scanning electron microscope (SEM). The obtained results showed that SMZ-TMP, SP and SP-metronidazole were effective against acute murine toxoplasmosis and caused deformities in the tachyzoites ultrastructure. SP-metronidazole gave the best results on both mice survival rate and parasite load in the brain and liver. SMZ-TMP induced formation of prominent filaments extending from the deformed tachyzoites. NTZ showed little effect. In conclusion, all used drugs succeeded to prolong the survival time of the mice. SP-metronidazole gave the foremost effect on both mice survival rate and parasite load in the liver, spleen and brain. As this combination is nontoxic to human, it is promising for the treatment of human toxoplasmosis.