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Antimicrobial Agents and Chemotherapy, February 2003, p. 620-625, Vol. 47, No. 2
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.2.620-625.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Effect of Amphotericin B on Larval Growth of Echinococcus multilocularis

Stefan Reuter,1 Marion Merkle,1 Klaus Brehm,2 Peter Kern,1* and Burkhard Manfras1

Section of Infectious Diseases and Clinical Immunology, Department of Internal Medicine, University Hospital of Ulm, 89081 Ulm,1 Institute for Hygiene and Microbiology, University of Würzburg, 97080 Würzburg, Germany2

Received 29 May 2002/ Returned for modification 26 August 2002/ Accepted 5 November 2002

Alveolar echinococcosis is caused by the parasitic cestode Echinococcus multilocularis. Benzimidazoles, namely, mebendazole and albendazole, are the only drugs available for the treatment of inoperable alveolar echinococcosis. At present, no therapeutic alternative is available for patients with progressive disease under treatment or for patients who are unable to tolerate the side effects of the benzimidazoles. In addition, benzimidazoles are only parasitostatic for E. multilocularis. Thus, new therapeutic options are of paramount importance. In the present study we examined the in vitro effect of amphotericin B on E. multilocularis larvae. E. multilocularis metacestodes grown in the peritoneal cavities of Mongolian gerbils were transferred into a culture system. Vesicles budded from the tissue blocks and increased in number and size during the first 5 weeks. After 6 weeks drugs were added and deleterious effects on the vesicles were observed macroscopically and microscopically. By use of this in vitro tissue culture model we demonstrated that amphotericin B effectively inhibits the growth of E. multilocularis metacestodes. This destructive effect was significantly more rapid with amphotericin B than with the benzimidazoles. Cyclic treatment was effective in suppressing parasite growth. However, amphotericin B appears to be parasitostatic for E. multilocularis larvae, and regrowth occurs even after extended periods. In summary, amphotericin B constitutes the first promising alternative for the treatment of alveolar echinococcosis in cases of intolerance or resistance to benzimidazoles. It holds promise as an effective treatment option for otherwise fatal courses of disease.

* Corresponding author. Mailing address: Section of Infectious Diseases and Clinical Immunology, University Hospital of Ulm, Robert-Koch-Str. 8, 89081 Ulm, Germany. Phone: 49-731-500-24420. Fax: 49-731-500-24422. E-mail: peter.kern{at}medizin.uni-ulm.de.

Antimicrobial Agents and Chemotherapy, February 2003, p. 620-625, Vol. 47, No. 2
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.2.620-625.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Reuter, S., Manfras, B., Merkle, M., Harter, G., Kern, P. (2006). In Vitro Activities of Itraconazole, Methiazole, and Nitazoxanide versus Echinococcus multilocularis Larvae.. Antimicrob. Agents Chemother. 50: 2966-2970 [Abstract] [Full Text]  
  • Mathis, A., Wild, P., Boettger, E. C., Kapel, C. M. O., Deplazes, P. (2005). Mitochondrial Ribosome as the Target for the Macrolide Antibiotic Clarithromycin in the Helminth Echinococcus multilocularis. Antimicrob. Agents Chemother. 49: 3251-3255 [Abstract] [Full Text]  
  • Reuter, S., Buck, A., Grebe, O., Nussle-Kugele, K., Kern, P., Manfras, B. J. (2003). Salvage Treatment with Amphotericin B in Progressive Human Alveolar Echinococcosis. Antimicrob. Agents Chemother. 47: 3586-3591 [Abstract] [Full Text]  


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