Toxoplasmose-Retinochorioiditis, ein Therapievergleich zwischen Spiramycin und Pyrimethamin/Sulfadiazin

BACKGROUND: The treatment of toxoplasma retinochoroiditis with spiramycin is an alternative to sulfadiazine and pyrimethamine. The treatment with sulfadiazine is associated with multiple side effects. Sulfadiazine is contraindicated during pregnancy and breastfeeding period. Spiramycin has less side effects and is recommended during pregnancy and breastfeeding period. The efficacy of spiramycin in treatment of toxoplasma retinochoroiditis is still a matter of controversy. PATIENTS AND METHODS: In a retrospective study, side effects and outcome of therapy in 44 patients with toxoplasma retinochoroiditis treated with sulfadiazine and pyrimethamine (n = 30) or spiramycin (n = 14) were compared. We assessed duration of therapy and healing, ophthalmoscopic findings and observed side effects. RESULTS: The mean healing time in the group of spiramycin was 63.83 days in comparison to 88 days for the group of patients treated with sulfadiazine/pyrimethamine. The frequency of side effects was lower in the group treated with spiramycin. CONCLUSION: In comparison to a combined application of sulfadiazine and pyrimethamine the treatment with spiramycin alone requires a shorter duration of therapy and healing period. Additionally, side effects and contraindications appear to be less frequent. In view of these findings, spiramycin therapy must be considered as a promising approach in the treatment of toxoplasma retinochoroiditis.