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Atovaquone is a broad-spectrum, anti-protozoal drug.
Its mechanism of action is via inhibition of the parasite's mitochondrial-electron
transport. Atovaquone is used in human medicine in combination with azithromycin
for the treatment of Babesia microti infection. It has a favorable
safety profile and appears to have fewer reports of adverse reactions
than some of the previous treatments for Babesia. Atovaquone is
also used in human medicine as an anti-malarial drug in the combination
drug "Malarone."
Atovaquone in combination with azithromycin is a promising new treatment for Babesia gibsoni in dogs. Babesia is a protozoal parasite of mammalian red blood cells and it is an emerging disease in many parts of the world. B. gibsoni infections are now widely endemic in the United States. There are two forms of Babesia that may infect dogs: the large Babesia (2-4 x 4-7?m) and the small Babesia (1.1-2 x 1.2-4?m). B. gibsoni is a small Babesia, as is Babesia microti, the protozoal species that infects humans.
The majority of cases of B. gibsoni found in the United States are in the Bull Terrier population, or in dogs that have been bitten by or have fought with a Bull Terrier. Natural vectors for B. gibsoni are ixodid ticks and the brown-dog tick Rhipicephalus sanguineus. Vertical transmission of B. gibsoni may also occur, as an infection has been found in a dam and her three day-old pups. Clinical infections are most frequent in young animals.
B. gibsoni infections have been hard to treat and have not responded well to previous anti-babesial drugs, such as imidocarb diproprionate. Although controlled studies have not been published, the combination of atovaquone with azithromycin may improve the recovery rate and is thought to produce fewer adverse reactions. One author states that 50% of treated animals become PCR negative in six weeks.
Atovaquone combined with azithromycin is also used in
the treatment of Cytauxzoon felis. C. felis is a serious tick-borne,
protozoal disease of cats. Although there are no controlled studies yet,
preliminary work using atovaquone and azithromycin suggest an improved
survival rate of >60%. The success rate for treatment of C. felis
with imidocarb was reported at 0-50%.
No information was found on the side effects of the atovaquone and azithromycin combination in animals. Malarone (atovaquone combined with proguanil hydrochloride) should not be used in dogs due to a high incidence of gastro-intestinal side effects.
In humans, the most commonly reported side effects to
the drug combination of atovaquone and azithromycin were diarrhea and
rash, and the most commonly reported side effects to Malarone were related
to the digestive tract. They included abdominal pain, nausea, vomiting,
anorexia and diarrhea.
• No information was found regarding specific precautions
for atovaquone in dogs or cats.
• No information was found regarding drug interactions for atovaquone.
• No information was found regarding overdose.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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