Skip to main content
  • ASM
    • Antimicrobial Agents and Chemotherapy
    • Applied and Environmental Microbiology
    • Clinical Microbiology Reviews
    • Clinical and Vaccine Immunology
    • EcoSal Plus
    • Eukaryotic Cell
    • Infection and Immunity
    • Journal of Bacteriology
    • Journal of Clinical Microbiology
    • Journal of Microbiology & Biology Education
    • Journal of Virology
    • mBio
    • Microbiology and Molecular Biology Reviews
    • Microbiology Resource Announcements
    • Microbiology Spectrum
    • Molecular and Cellular Biology
    • mSphere
    • mSystems
  • Log in
  • My alerts
  • My Cart

Main menu

  • Home
  • Articles
    • Current Issue
    • Accepted Manuscripts
    • COVID-19 Special Collection
    • Archive
    • Minireviews
  • For Authors
    • Submit a Manuscript
    • Scope
    • Editorial Policy
    • Submission, Review, & Publication Processes
    • Organization and Format
    • Errata, Author Corrections, Retractions
    • Illustrations and Tables
    • Nomenclature
    • Abbreviations and Conventions
    • Publication Fees
    • Ethics Resources and Policies
  • About the Journal
    • About AAC
    • Editor in Chief
    • Editorial Board
    • For Reviewers
    • For the Media
    • For Librarians
    • For Advertisers
    • Alerts
    • AAC Podcast
    • RSS
    • FAQ
  • Subscribe
    • Members
    • Institutions
  • ASM
    • Antimicrobial Agents and Chemotherapy
    • Applied and Environmental Microbiology
    • Clinical Microbiology Reviews
    • Clinical and Vaccine Immunology
    • EcoSal Plus
    • Eukaryotic Cell
    • Infection and Immunity
    • Journal of Bacteriology
    • Journal of Clinical Microbiology
    • Journal of Microbiology & Biology Education
    • Journal of Virology
    • mBio
    • Microbiology and Molecular Biology Reviews
    • Microbiology Resource Announcements
    • Microbiology Spectrum
    • Molecular and Cellular Biology
    • mSphere
    • mSystems

User menu

  • Log in
  • My alerts
  • My Cart

Search

  • Advanced search
Antimicrobial Agents and Chemotherapy
publisher-logosite-logo

Advanced Search

  • Home
  • Articles
    • Current Issue
    • Accepted Manuscripts
    • COVID-19 Special Collection
    • Archive
    • Minireviews
  • For Authors
    • Submit a Manuscript
    • Scope
    • Editorial Policy
    • Submission, Review, & Publication Processes
    • Organization and Format
    • Errata, Author Corrections, Retractions
    • Illustrations and Tables
    • Nomenclature
    • Abbreviations and Conventions
    • Publication Fees
    • Ethics Resources and Policies
  • About the Journal
    • About AAC
    • Editor in Chief
    • Editorial Board
    • For Reviewers
    • For the Media
    • For Librarians
    • For Advertisers
    • Alerts
    • AAC Podcast
    • RSS
    • FAQ
  • Subscribe
    • Members
    • Institutions
Pharmacology

Tolerance of Benznidazole in Treatment of Chagas' Disease in Adults

María-Jesús Pinazo, José Muñoz, Elizabeth Posada, Paulo López-Chejade, Montserrat Gállego, Edgar Ayala, Elena del Cacho, Dolors Soy, Joaquim Gascon
María-Jesús Pinazo
1Tropical Diseases Section, Barcelona Center for International Health Research (CRESIB), Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
José Muñoz
1Tropical Diseases Section, Barcelona Center for International Health Research (CRESIB), Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elizabeth Posada
1Tropical Diseases Section, Barcelona Center for International Health Research (CRESIB), Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Paulo López-Chejade
2Laboratori de Parasitologia, Facultat de Farmàcia, Universitat de Barcelona, Joan XXIII Avenue, s/n 08028 Barcelona, Spain
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Montserrat Gállego
2Laboratori de Parasitologia, Facultat de Farmàcia, Universitat de Barcelona, Joan XXIII Avenue, s/n 08028 Barcelona, Spain
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Edgar Ayala
3Center for International Health Research (CRESIB), Roselló 132, 08036 Barcelona, Spain
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elena del Cacho
4Pharmacology Department, Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dolors Soy
4Pharmacology Department, Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joaquim Gascon
1Tropical Diseases Section, Barcelona Center for International Health Research (CRESIB), Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: mpinazo@clinic.ub.es
DOI: 10.1128/AAC.00537-10
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

ABSTRACT

Chagas’ disease is an emerging public health problem in areas where the disease is not endemic. Treatment with benznidazole has shown efficacy in the acute stage of the disease, but its efficacy in the chronic stage remains controversial, and unwanted side effects are more frequent and severe in adults than in children. This study describes the profile of side effects of benznidazole in a cohort of Trypanosoma cruzi-infected patients in a European country.

Chagas’ disease is a traditionally rural Latin American disease that affects 8 to 10 million people (12). Its causal agent, Trypanosoma cruzi, is mainly transmitted by a triatomid vector that is endemic in most countries of Latin America. Other routes of transmission, which can also occur in countries where the vector is not present, are blood transfusion, organ transplant, and mother-to-child transmission (14). The acute phase of Chagas’ disease usually presents few or no symptoms; some patients experience fever, lymphadenopathy, splenomegaly, and/or edema, but rarely severe disease. Without treatment, around 5 to 10% of patients with severe disease die (14). After the acute phase, T. cruzi-infected individuals pass into a clinically silent chronic phase (14). However, over a period of 10 to 30 years, 20 to 35% of patients develop symptomatic chronic Chagas’ disease that is mainly characterized by cardiac and/or gastrointestinal disorders.

Treatment with the currently used drugs (benznidazole and nifurtimox) in this phase of the disease provides cure rates of close to 100% in infants (16) and around 60% in children and adults with recent infection (4, 19). The efficacy of drug therapy declines with the duration of infection and is still a matter of debate in the late chronic phase of Chagas’ disease (18).

Chagas’ disease is no longer limited to areas of endemicity and has recently become a public health problem in the United States and in most European countries receiving immigrants from Latin America, where the disease is endemic (8, 11). The most widely available drug for treating the disease is benznidazole.

In adults, benznidazole has a high rate of adverse effects, which can be classified into three groups: (i) hypersensitivity, including dermatitis with cutaneous eruptions (usually appearing between days 7 and 10), myalgias, arthralgias, and lymphadenopathy; (ii) polyneuropathy, paresthesias, and polyneuritis (usually during the 4th week of treatment); and (iii) bone marrow disorders, such as thrombopenic purpura and agranulocytosis (usually after the second week of treatment) (17).

Despite the high efficacy in acute infections, treatment in chronic stages is controversial and the true efficacy in these stages is unknown (10). However, recent studies have demonstrated that treatment with benznidazole can restrict the progression of Chagas’ disease (23) and increase long-term negative seroconversion in patients in an early indeterminate phase (4).

The main aim of this study was to describe and discuss the side effects of benznidazole in a cohort of T. cruzi-infected patients in chronic and indeterminate stages living in Barcelona, Spain.

We performed a descriptive observational study in the Center for International Health, in the Hospital Clinic, a university hospital in the center of Barcelona. At the time the study was performed, around 67,000 Latin American migrants lived in this city. The majority of the migrant population attending the Center for International Health came from Latin America, in particular from Bolivia.

Participants were selected from the Latin American population attending the clinical unit, regardless of the reason for the visit, from June 2005 to November 2008. Participants were included in the study if they fulfilled the following four inclusion criteria: (i) having been born in a country where Chagas’ disease is endemic (ii) having a confirmed diagnosis of T. cruzi infection (by two serological enzyme-linked immunosorbent assays [ELISAs], following international recommendations [24]), (iii) having consented to receive treatment with benznidazole during the study term, and (iv) having signed the informed-consent form. Patients that had previously received treatment with benznidazole or nifurtimox were excluded. Participants were followed by clinicians for up to 60 days.

According to the in-hospital protocol for Chagas’ disease treatment, an electrocardiogram and a chest X-ray were performed for all patients. An esophagogram and a barium enema were only prescribed for patients with gastrointestinal symptoms. In addition, a real-time PCR (RT-PCR) (13) was performed on blood samples of all patients before and 6 months after treatment. All patients were treated with 5 mg/kg of body weight/day of benznidazole for 60 days, with fortnightly medical visits, including a hemogram and biochemistry tests (including hepatic and renal function).

A descriptive analysis was performed. Frequencies, means, and standard deviations were calculated using Stata 9 (20).

All patients invited to participate accepted to sign the informed consent form after receiving the information. A total of 105 participants received benznidazole 5 mg/kg/day (100 mg/tablet; Radanil, Roche) for 60 days. Most of them were women (85/105, 80%), and they had a mean age of 38.7 years (range, 16 to 58). The most frequent country of origin was Bolivia (85.7%), followed by Argentina (9.5%), with only one case each from Colombia, Ecuador, Paraguay, and Peru. All participants were in the chronic stage of the disease. Thirteen (12.4%) had cardiac disorders, and 3 (2.8%) digestive disorders (one with degree I esophagopathy and two with dolichocolon). Sixty of the 105 (57.1%) patients presented one or more adverse events, and 45 of 105 (42.9%) were asymptomatic during the follow-up. Forty-five percent (27 of 60) of the patients presenting with adverse events presented more than one symptom attributed to benznidazole during the treatment period. Side effects during the treatment are shown in Table 1, and examples of the most common skin presentations in Fig. 1 and 2.

Eighty-nine patients (83.8%) completed treatment, while 8 patients (7.6%) had to discontinue due to fever and severe urticaria and 2 other cases (1.4%) due to poor gastrointestinal tolerance (both were in the indeterminate stage of the disease, without pretherapy digestive involvement). Four patients were lost to follow-up after starting treatment.

26 patients had positive blood RT-PCRs for T. cruzi before treatment, 5 of which remained positive after completing full treatment, indicating therapeutic failure. In 3 of these 5 patients, the first RT-PCR after treatment was positive, but in the other two patients, RT-PCR was positive 2 years later during the follow-up.

The emergence of Chagas’ disease in areas where it is not endemic is currently a public health challenge, and one of the main limitations is the lack of experience in managing adverse events caused by specific treatment against T. cruzi. A wide range of side effects were found in the 105 patients treated with benznidazole in this geographic area where T. cruzi is not endemic, with an incidence similar to and even higher than those previously reported (22). Nonetheless, our results are similar to those obtained in systematically controlled trials designed specifically for this purpose (17), probably due to the close follow-up (every 15 days during treatment) and the application of questionnaires to check for the appearance of side effects on each visit.

The use of RT-PCR allowed us to confirm treatment failure in 5 of 26 (19.2%) of patients. As shown by other studies, repeated PCR testing may indicate that the true treatment failure rate is higher (6).

Though adverse events related to benznidazole have been described mainly in the first 2 weeks of treatment (22), we observed that they appeared during the whole treatment.

Not many studies describing adverse events related to benznidazole in T. cruzi-infected adults in the chronic or indeterminate stage of the disease have been reported. Before 1990, small studies with various regimens of drug administration were published (2, 7, 9). Since 1990, larger studies have been reported (1, 5, 17, 21, 23, 25). The most common adverse event related to benznidazole in our study was headache, described in other studies but not so frequently, with an incidence of 2 to 18% (9, 21, 23). It mainly appeared during the first 15 days and was usually well controlled by symptomatic treatment, but it could persist while benznidazole was being administered.

Dermatological events have been described in other works as the main side effect of this drug. Urticaria, the most common dermatological side effect, has been described to appear in 18 to 56% of patients during the first 10 days of treatment with benznidazole (1, 2, 3, 5, 7, 9, 21, 23, 25). We observed that in 13 of 23 patients, urticaria appeared in this 15-day period, but in 6 of 23 patients, urticaria appeared in the second fortnight, and in 4 of 23, in the second month of treatment.

Articular involvement and paresthesia (as a symptom of peripheral polyneuritis), are serious toxic effects induced by benznidazole, appearing mainly at the end of the treatment, as has been described previously (1). We observed a higher rate of patients with this toxic event than has been described in other studies, which reported it in 10 to 18% of patients (25). In studies previous to 1990, a high rate of this adverse event was recorded (25 to 45%), probably due to high dose regimens used in those studies (2, 9).

Gastrointestinal disorders were not as common in our study as in other studies, in which they have been described to appear in 13 to 27% of patients (9, 17, 25). Viotti et al. described a 5% incidence of digestive side effects (23), which appeared only when the patients did not follow a specific diet indicated during the treatment, and anorexia, which was observed in 40% of our patients, was not recorded in any patient in Viotti's studies.

The appearance of fever in patients treated with benznidazole is a criterion of severity. In other reports, it was described as a symptom that appeared with dermatological events (1, 3, 25), but Viotti et al. (23) described fever in 0.9% of patients and Sosa Estani et al. in 6% (17) of patients. In our study, it was recorded in 12 (11%) patients, and in 6 cases, it presented with urticaria.

Our results concur with the fact that no cumulative effect of benznidazole serum concentrations is expected during treatment, so the probability of side effects appearing might be similar over time (15), unless the side effect that appears is a hypersensitivity reaction.

In most cases, the side effects were well controlled with symptomatic treatment. Treatment was stopped in 9% of patients, fewer than reported in previous studies with benznidazole (17, 22), but no life-threatening side effects were observed. Only one patient who had to stop the treatment was in the chronic stage of the disease, with digestive involvement in particular, but the reason for stopping benznidazole was a severe urticaria with fever. The results of our study may be explained by the fact that we recorded clinically observed side effects and specific medical histories every 15 days.

Little is known about the pharmacokinetics of benznidazole. To date, the therapeutic range has been defined as 3 to 6 mg/liter, and serum concentrations >20 mg/liter seem to be associated with more side effects (15). Based on the pharmacokinetic profile of benznidazole, serum drug concentrations are expected to be lower than 20 mg/liter (15) with the current regime of 5 mg/kg/day (split into two doses, every 12 h). Nonetheless, there is a high incidence of side events that can be severe in some patients.

Until new, better drugs or combined therapies become available for Chagas’ disease treatment, the current treatment with benznidazole and nifurtimox must be improved and patients treated with these drugs must be strictly monitored during the follow-up.

Our study was carried out in Barcelona, an urban area with good access to health services where Chagas’ disease is not endemic. The conclusions and lessons of our study are difficult to replicate in rural areas of endemicity, where the access of patients to the health system is usually limited.

FIG. 1.
  • Open in new tab
  • Download powerpoint
FIG. 1.

Pruriginous maculopapular rash on limbs of a patient receiving benznidazole.

FIG. 2.
  • Open in new tab
  • Download powerpoint
FIG. 2.

Palmar rash in a patient receiving benznidazole, a concomitant manifestation with micropapular rash and urticaria.

View this table:
  • View inline
  • View popup
TABLE 1.

Adverse events related to antiparasitic treatment with benznidazol in T. cruzi-infected patients

ACKNOWLEDGMENTS

The study was supported by the Hospital Clinic of Barcelona; no outside funding of any kind was received. We thank the Fundación Mundo Sano (Spain) for providing support to our group and to research into Chagas’ disease.

All the authors contributed to the literature search and writing the text. María-Jesús Pinazo, José Muñoz, Elizabeth Posada, and Joaquim Gascon led the clinical management of the patients and designed the study. Elena del Cacho and Dolors Soy contributed to the design of the study and conducted the critical review of drug side effects based on their previous experience in antiparasitic drugs. Montserrat Gállego and Paulo López-Chejade performed laboratory support for T. cruzi serology and RT-PCR. Edgar Ayala analyzed and interpreted the data.

The authors have no conflicts of interest.

FOOTNOTES

    • Received 20 April 2010.
    • Returned for modification 22 June 2010.
    • Accepted 29 August 2010.
  • Copyright © 2010 American Society for Microbiology

REFERENCES

  1. 1.↵
    Cançado, J. R. 2002. Long term evaluation of etiological treatment of Chagas’ disease with benznidazole. Rev. Inst. Med. Trop. Sao Paulo44:29-37.
    OpenUrlCrossRefPubMed
  2. 2.↵
    Carpintero, D. J. 1983. Uso del ácido tióctico para la prevención de los efectos secundarios provocados por el benznidazol en pacientes con enfermedad de Chagas crónica. Medicina (B. Aires).43:285-290.
    OpenUrlPubMed
  3. 3.↵
    Coura, R. J., and S. L. de Castro. 2002. A critical review on Chagas’ disease chemotherapy. Mem. Inst. Oswaldo Cruz97:3-24.
    OpenUrlCrossRefPubMed
  4. 4.↵
    de Andrade, A. L., F. Zicker, R. M. de Oliveira, S. Almeida Silva, A. Luquetti, L. R. Travassos, I. C. Almeida, S. S. de Andrade, J. G. de Andrade, and C. M. Martelli. 1996. Randomized trial of efficacy of benznidazole in treatment of early Trypanosoma cruzi infection. Lancet348:1407-1413.
    OpenUrlCrossRefPubMedWeb of Science
  5. 5.↵
    Fabbro, D. L., M. L. Streiger, E. D. Arias, M. L. Bizai, M. del Barco, and N. A. Amicone. 2007. Trypanocide treatment among adults with chronic Chagas’ disease living in Santa Fe city (Argentina), over a mean follow-up of 21 years: parasitological, serological and clinical evolution. Rev. Soc. Bras. Med. Trop.40:1-10.
    OpenUrlCrossRefPubMedWeb of Science
  6. 6.↵
    Fernandes, C. D., F. M. Tiecher, M. M. Balbinot, D. B. Liarte, D. Scholl, M. Steindel, and A. Romanha. 2009. Efficacy of benznidazol treatment for asymptomatic chagasic patients from state of Rio Grande do Sul evaluated during a three years follow-up. Mem. Inst. Oswaldo Cruz104:27-32.
    OpenUrlCrossRefPubMedWeb of Science
  7. 7.↵
    Ferreira, H. D. 1976. Clinico-therapeutic trial with benzonidazole in Chagas' disease. Rev. Inst. Med. Trop. Sao Paulo.8:357-364.
    OpenUrl
  8. 8.↵
    Gascon, J., C. Bern, and M. J. Pinazo. 2010. Chagas’ disease in Spain, the United States and other non-endemic countries. Acta Trop.115:22-27.
    OpenUrlCrossRefPubMedWeb of Science
  9. 9.↵
    Levi, G. C., V. Amato Neto, and I. F. Sant'anna. 1975. Análise de manifestaçoes colaterais devidas ao uso do medicamento Ro 7-1051, nitroimidazólico preconizado para tentativas de tratamento espscífico na doença de Chagas. Rev. Inst. Med. Trop. Sao Paulo18:357-364.
    OpenUrl
  10. 10.↵
    Marin-Neto, J. A., A. Rassi, Jr., C. A. Morillo, A. Avezum, S. J. Connolly, S. Sosa-Estani, F. Rosas, and S. Yusuf. 2008. Rationale and design of a randomized placebo-controlled trial assessing the effects of etiologic treatment in Chagas' cardiomyopathy: the BENznidazole Evaluation For Interrupting Trypanosomiasis (BENEFIT). Am. Heart J.156:37-43.
    OpenUrlCrossRefPubMedWeb of Science
  11. 11.↵
    Muñoz, J., J. Gómez i Prat, M. Gállego, F. Gimeno, B. Treviño, P. López-Chejade, O. Ribera, L. Molina, S. Sanz, M. J. Pinazo, C. Riera, E. J. Posada, G. Sanz, M. Portús, and J. Gascon. 2009. Clinical profile of Trypanosoma cruzi infection in a non-endemic setting: immigration and Chagas’ disease in Barcelona (Spain). Acta Trop.111:51-55.
    OpenUrlCrossRefPubMedWeb of Science
  12. 12.↵
    Organización Panamericana de la Salud. 2006. Estimación cuantitativa de la enfermedad de Chagas en las Americas. Organización Panamericana de la Salud (OPS), Montevideo, Uruguay.
  13. 13.↵
    Piron, M., R. Fisa, N. Casamitjana, P. López-Chejade, L. Puig, M. Vergés, J. Gascón, J. Gómez i Prat, M. Portus, and S. Sauleda. 2007. Development of a real-time PCR assay for Trypanosoma cruzi detection in blood samples. Acta Trop.103:195-200.
    OpenUrlCrossRefPubMedWeb of Science
  14. 14.↵
    Prata, A. 2001. Clinical and epidemiological aspects of Chagas’ disease. Lancet Infect. Dis.1:92-100.
    OpenUrlCrossRefPubMed
  15. 15.↵
    Raaflaub, J., and W. H. Ziegler. 1979. Multiple-dose kinetics of the trypanosomicide benznidazole in man. Drug Res.29:1611-1614.
    OpenUrlPubMed
  16. 16.↵
    Schijman, A. G., J. Altcheh, J. M. Burgos, M. Biancardi, M. Bisio, M. J. Levin, and H. Freilij. 2003. Aetiological treatment of congenital Chagas' disease diagnosed and monitored by the polymerase chain reaction. J. Antimicrob. Chemother.52:441-449.
    OpenUrlCrossRefPubMedWeb of Science
  17. 17.↵
    Sosa Estani, S., A. Armenti, G. Araujo, R. Viotti, B. Lococo, B. Ruiz Vera, C. Vigliano, A. M. de Rissio, and E. L. Segura. 2004. Treatment of Chagas’ disease with benznidazole and thioctic acid. Medicina (B. Aires)64:1-6.
    OpenUrlPubMedWeb of Science
  18. 18.↵
    Sosa Estani, S., and E. L. Segura. 2006. Etiological treatment in patients infected by Trypanosoma cruzi: experiences in Argentina. Curr. Opin. Infect. Dis.19:583-587.
    OpenUrlCrossRefPubMedWeb of Science
  19. 19.↵
    Sosa Estani, S., E. L. Segura, A. M. Ruiz, E. Velazquez, B. M. Porcel, and C. Yampotis. 1998. Efficacy of chemotherapy with benznidazole in children in the indeterminate phase of Chagas' disease. Am. J. Trop. Med. Hyg.59:526-529.
    OpenUrlAbstract
  20. 20.↵
    Stata Corp. 2007. Stata Statistical Software, release 10. StataCorp LP, College Station, TX.
  21. 21.↵
    Viotti, R., C. Vigliano, H. Armenti, and E. Segura. 1994. Treatment of chronic Chagas' disease with benznidazole: clinical and serologic evolution of patients with long-term follow-up. Am. Heart J.127:151-162.
    OpenUrlCrossRefPubMedWeb of Science
  22. 22.↵
    Viotti, R., C. Vigliano, B. Lococo, M. G. Alvarez, M. Petti, G. Bertochi, and A. Armenti. 2009. Side effects of benznidazole as treatment in chronic Chagas’ disease: fears and realities. Expert Rev. Anti Infect. Ther.7:157-163.
    OpenUrlCrossRefPubMedWeb of Science
  23. 23.↵
    Viotti, R., C. Vigliano, B. Lococo, G. Bertocchi, M. Petti, M. G. Alvarez, M. Postan, and A. Armenti. 2006. Long-term cardiac outcomes of treating Chagas’ disease with benznidazole versus non treatment. Ann. Inter Med.144:724-734.
    OpenUrlCrossRefPubMedWeb of Science
  24. 24.↵
    World Health Organization (WHO). 2002. Control of Chagas’ disease. World Health Organ. Tech. Rep. Ser.905:1-109.
    OpenUrl
  25. 25.↵
    Yun, O., M. A. Lima, T. Ellman, W. Chambi, S. Castillo, L. Flevaud, P. Roddy, F. Parreño, P. Abajar Viñas, and P. P. Palma. 2009. Feasibility, drug safety, and effectiveness of etiological treatment programs for Chagas’ disease in Honduras, Guatemala, and Bolivia: 10-year experience of Médecins Sans Frontières. PLoS Negl. Trop. Dis.3:e488.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top
Download PDF
Citation Tools
Tolerance of Benznidazole in Treatment of Chagas' Disease in Adults
María-Jesús Pinazo, José Muñoz, Elizabeth Posada, Paulo López-Chejade, Montserrat Gállego, Edgar Ayala, Elena del Cacho, Dolors Soy, Joaquim Gascon
Antimicrobial Agents and Chemotherapy Oct 2010, 54 (11) 4896-4899; DOI: 10.1128/AAC.00537-10

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Print

Alerts
Sign In to Email Alerts with your Email Address
Email

Thank you for sharing this Antimicrobial Agents and Chemotherapy article.

NOTE: We request your email address only to inform the recipient that it was you who recommended this article, and that it is not junk mail. We do not retain these email addresses.

Enter multiple addresses on separate lines or separate them with commas.
Tolerance of Benznidazole in Treatment of Chagas' Disease in Adults
(Your Name) has forwarded a page to you from Antimicrobial Agents and Chemotherapy
(Your Name) thought you would be interested in this article in Antimicrobial Agents and Chemotherapy.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Share
Tolerance of Benznidazole in Treatment of Chagas' Disease in Adults
María-Jesús Pinazo, José Muñoz, Elizabeth Posada, Paulo López-Chejade, Montserrat Gállego, Edgar Ayala, Elena del Cacho, Dolors Soy, Joaquim Gascon
Antimicrobial Agents and Chemotherapy Oct 2010, 54 (11) 4896-4899; DOI: 10.1128/AAC.00537-10
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Top
  • Article
    • ABSTRACT
    • ACKNOWLEDGMENTS
    • FOOTNOTES
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • PDF

KEYWORDS

Chagas disease
nitroimidazoles
Trypanocidal Agents

Related Articles

Cited By...

About

  • About AAC
  • Editor in Chief
  • Editorial Board
  • Policies
  • For Reviewers
  • For the Media
  • For Librarians
  • For Advertisers
  • Alerts
  • AAC Podcast
  • RSS
  • FAQ
  • Permissions
  • Journal Announcements

Authors

  • ASM Author Center
  • Submit a Manuscript
  • Article Types
  • Ethics
  • Contact Us

Follow #AACJournal

@ASMicrobiology

       

ASM Journals

ASM journals are the most prominent publications in the field, delivering up-to-date and authoritative coverage of both basic and clinical microbiology.

About ASM | Contact Us | Press Room

 

ASM is a member of

Scientific Society Publisher Alliance

 

American Society for Microbiology
1752 N St. NW
Washington, DC 20036
Phone: (202) 737-3600

Copyright © 2021 American Society for Microbiology | Privacy Policy | Website feedback

Print ISSN: 0066-4804; Online ISSN: 1098-6596