Ascariasis and Enterobiasis Pyrantel pamoate is used for the treatment of ascariasis (roundworm infection) caused by Ascaris lumbricoides and enterobiasis (pinworm infection) caused by Enterobius vermicularis. The drug may be used for self-medication of enterobiasis.
Praziquantel is used for the treatment of schistosomiasis (bilharziasis) caused by all Schistosoma species pathogenic to humans. The drug has been used effectively for the treatment of individual patients and in mass-treatment and control programs. Praziquantel is effective against all stages of Schistosoma infection including the acute phase and the chronic phase which may be associated with hepatosplenic involvement. The drug appears to be effective in the treatment of severe schistosomiasis (e.g., neuroschistosomiasis); however, to prevent substantial morbidity and long-term sequelae (e.g., paraplegia, persistent impotence) associated with this condition, therapy with praziquantel must be initiated promptly.
Mebendazole is used for the treatment of a variety of nematode (roundworm) infections, including trichuriasis (whipworm infection) caused by Trichuris trichiura, enterobiasis (pinworm infection) caused by Enterobius vermicularis, ascariasis (roundworm infection) caused by Ascaris lumbricoides, and hookworm infections caused by Ancylostoma duodenale, Necator americanus, or Ancylostoma caninum.
Albendazole is used in the treatment of tissue infections caused by the larval forms of certain cestodes (tapeworms) including neurocysticercosis caused by Cysticercus cellulosae, the larval form of Taenia solium (pork tapeworm). Albendazole also is used for the treatment of hydatid disease caused by the larval form of Echinococcus granulosus (dog tapeworm). Other anthelmintics (usually praziquantel) are used for the treatment of intestinal infections caused by adult forms of cestodes. Albendazole is used for the treatment of parenchymal neurocysticercosis resulting from active lesions caused by Cysticercus cellulosae, the larval form of Taenia solium (pork tapeworm), preferably in combination with corticosteroids.
TABLE: Emerging Therapies in Development for Community-Acquired Pneumonia, 2004 summarizes emerging antibacterial agents in late-stage development and their expected sales potential in the community-acquired pneumonia market.
Fluoroquinolones act by inhibiting bacterial topoisomerase IV and DNA gyrase, which are enzymes required for DNA replication, transcription, repair, and recombination. The exact nature of the interaction of quinolones with their target enzymes is not completely understood.
Cefpodoxime proxetil is an esterified pro-drug of cefpodoxime created for oral formulation. It is stable in the presence of most β-lactamase enzymes, effectively extending its spectrum of activity against several gram-positive and gram-negative bacteria that are resistant to penicillins and other cephalosporins.
Many highly effective agents are available for the treatment of bacterial community-acquired pneumonia (community-acquired pneumonia) and other community-acquire respiratory tract infections (RTIs). Currently marketed antibiotics for community-acquired pneumonia demonstrate similar efficacy rates in clinical trials, and these agents have generally achieved clinical symptom resolution in 85-95% of trial participants.
Antimicrobial resistance in Streptococcus pneumoniae and other community-acquired pneumonia pathogens has progressed at an alarming rate. Approximately one-third of pneumococci exhibit reduced susceptibility to penicillin (i.e., higher MICs) that also confers reduced susceptibility to other agents in the β-lactam class of antibiotics. Macrolide resistance levels range between 23% and 30% in the United States, and much higher levels are observed in some other markets. N.
The penicillins comprise several subgroups of agents with a wide range of bacterial coverage and efficacy. Each penicillin molecule contains a basic β-lactam structure fused to a five-membered ring. Because of their broad spectrum of activity and availability in oral form, the penicillins are commonly used in the treatment of community-acquired pneumonia and have become the drugs of choice in treating many common infections.