Efficacy of azithromycin combined with compounded atovaquone in treating babesiosis in giant pandas

Parasit Vectors. 2024 Dec 23;17(1):531. doi: 10.1186/s13071-024-06615-9.

Abstract

Background: Babesia is a tick-borne protozoan blood parasite that can cause hemolytic anemia, thrombocytopenia, lethargy and splenomegaly in giant pandas.

Methods: We evaluated the efficacy and safety profile of a therapeutic regimen combining atovaquone and zithromycin in the context of babesiosis in giant pandas that have been naturally infected. The examined pandas underwent clinical and laboratory analyses, including hematology, biochemistry and thyroid hormone profiles. Upon diagnosis, the giant pandas were administered a compounded treatment consisting of atovaquone oral suspension (15 mg/kg, PO, q8 h), azithromycin tablets (10 mg/kg, PO, q24 h) and Enteral Nutritional Suspension (TPF) as a fat-rich supplement (0.5 ml/kg, PO, q8 h) for a 10-day period.

Results: The combination treatment increased the red blood cell count, hemoglobin levels and hematocrit in the pandas within a short period, while also reducing parasite levels below the PCR detection threshold.

Conclusions: Our study suggested that atovaquone and azithromycin combination therapy is highly effective for emergency treatment of Babesia sp. infection in giant pandas.

Keywords: Babesia; Atovaquone; Azithromycin; Clinical efficacy; Compounded treatment; Giant panda.

MeSH terms

  • Animals
  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / therapeutic use
  • Atovaquone* / administration & dosage
  • Atovaquone* / therapeutic use
  • Azithromycin* / administration & dosage
  • Azithromycin* / therapeutic use
  • Babesia* / drug effects
  • Babesiosis* / drug therapy
  • Babesiosis* / parasitology
  • Drug Therapy, Combination
  • Treatment Outcome
  • Ursidae* / parasitology

Substances

  • Azithromycin
  • Atovaquone
  • Antiprotozoal Agents