atovaquone / Generic mfg. - LARVOL DELTA

Infection Prophylaxis in CAR T-Cell Therapy (ICBMT 2025) - "NCCN and ASTCT guidelines support the use of acyclovir 400 mg PO twice daily or valacyclovir 500 mg PO twice daily for at least six months after CAR T infusion and until CD4 T -cell counts exceed 200/µL. Hepatitis B virus (HBV) management should include entecavir or tenofovir for at least 12 months in HBsAg -positive patients and longer if immunosuppression persists; anti -HBc–positive/HBsAg -negative patients may receive prophylaxis or undergo monthly HBV DNA monitoring...Alternatives include atovaquone 1500 mg daily, dapsone 100 mg daily (after G6PD testing), or monthly aerosolized pe ntamidine for those with sulfa allergy or intolerance. Fungal Fluconazole is recommended during periods of neutropenia until neutrophil recovery. High -risk patients — those with pre -infusion neutropenia, prior invasive fungal infection within six months, prior allo -HCT, grade ≥3 CRS/ICANS, or prolonged high -dose cortic osteroids (>72 h) —should receive mould -active..."

CAR T-Cell Therapy • Hematological Malignancies • Hepatitis B • Hepatology • Herpes Zoster • Immunology • Infectious Disease • Influenza • Meningococcal Infections • Neutropenia • Pertussis • Pneumococcal Infections • Pneumonia • Respiratory Diseases • Tetanus • CD4

A Case of Catastrophic Antiphospholipid Syndrome Manifesting as Abdominal Pain (ACG 2025) - "He was treated with another steroid course, plasmapheresis, and Rituximab, with significant improvement. He was discharged home on prednisone, atovaquone, pantoprazole, warfarin, and vitamin D. This is a rare case of CAPS presenting as non-specific abdominal pain following warfarin discontinuation...Figure: Figures 1A-C: Initial CT A/P of the liver reveals an enlarged spleen and gastric distention without evidence of infarction​.Figures 1D-F: Repeat CT A/P imaging done after APS flare-up, four days after initial presentation. Multiple new hypoattenuating lesions in the liver are visible, consistent with multiple infarcts.Figure: Figures 2A-2C: Esophagogastroduodenoscopy to work up gastric distension showed diffuse inflammation indicating gastritis in the body and upper body of the stomach (2A, 2B), with scattered gastric purpura in the antrum (2C)."

Clinical • Acute Kidney Injury • Cardiovascular • Complement-mediated Rare Disorders • Gastrointestinal Disorder • Genetic Disorders • Hematological Disorders • Hepatology • Immunology • Inflammation • Inflammatory Arthritis • Ischemic stroke • Nephrology • Pain • Peptic Ulcer • Renal Disease • Rheumatoid Arthritis • Rheumatology • Thrombocytopenia • Thrombosis

Babesiosis-induced warm autoimmune hemolytic anemia, from infection to hemolysis: a case report. (PubMed, J Med Case Rep) - "Given the increasing prevalence of tick-borne illnesses, physicians should have a high index of suspicion for concurrent warm autoimmune hemolytic anemia in patients with babesiosis and anemia not improving with typical therapies. In addition, the interplay between babesiosis and warm autoimmune hemolytic anemia underscores the need for clinicians to consider infectious etiologies in the workup of this disease."

Journal • Review • Anemia • Autoimmune Hemolytic Anemia • Hematological Disorders • Immunology • Infectious Disease

The repurposed STAT3 inhibitor pyrimethamine controls mycobacterial infection-induced vascular permeability and mycobacterial burden. (PubMed, Biomed Pharmacother) - "Here using the zebrafish-Mycobacterium marinum infection model, we confirm a critical role for Signal transducer and activator of transcription 3 (STAT3) in mediating infection-induced vascular permeability, and demonstrate the ability of FDA-approved drugs atovaquone (Mepron) and pyrimethamine (Daraprim) to restore vascular barrier function without compromising innate immune control of mycobacterial infection. We find an additional antibiotic effect of pyrimethamine against M. marinum and M. tuberculosis. Together our findings suggest pyrimethamine could be used as adjunctive therapy against mycobacterial infection and explain the protective effect of Daraprim prophylaxis against tuberculosis diagnosis in HIV positive populations."

Journal • Human Immunodeficiency Virus • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis • STAT3

Treatment of Dapsone-Induced Methemoglobinemia in a Transplant Recipient With Isosulfan Blue Allergy (ACG 2025) - "1 month post-LT, pneumocystis jirovecii pneumonia (PJP) prophylaxis was switched from sulfamethoxazole/trimethoprim (SMZ/TMP) to dapsone due to renal impairment...Dapsone was switched to atovaquone, which was not tolerated due to nausea; and was restarted 21 days later. Other medications included tacrolimus, cellcept and valcyte...Cimetidine use was weighed with balancing the risks for kidney injury due to acute interstitial nephritis with recent KT with improvement in MethHb.Figure: Figure 1. Methemoglobin Level after Cimetidine Initiation*Day of Cimetidine 400mg TID for 5 days initiation"

Clinical • Allergy • Anemia • Fatigue • Fibrosis • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Leukopenia • Metabolic Dysfunction-Associated Steatohepatitis • Nephrology • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • Transplantation • G6PD • HP

Atovaquone-proguanil and reduced digestive cancer risk: a Toxoplasma gondii connection. (PubMed, Gut Microbes) - "These findings suggest T. gondii may be an overlooked microbial risk factor for digestive cancers, and that A-P may offer chemopreventive effects through antiparasitic activity. Prospective studies are needed to evaluate its preventive potential."

Journal • Retrospective data • Colorectal Cancer • Gastrointestinal Cancer • Infectious Disease • Oncology • Pancreatic Cancer • Solid Tumor

Breakthroughs in the development of antibiotics, antifungals and antiparasitics targeting the pathogens' respiratory chain. (PubMed, Crit Rev Biochem Mol Biol) - "Because of robust antimicrobial resistance against the traditional mechanisms of microbial control (cell wall integrity, protein synthesis, nucleotide and nucleic acid synthesis, etc.), the study of alternative targets, such as the respiratory chain, is prudent and timely. This review summarizes the current research on small molecule and peptide inhibition of the aerobic respiratory chain complexes, electron flow, and ion translocation in a series of human and plant pathogens."

Journal • Review

Review of Toxoplasmosis: What We Still Need to Do. (PubMed, Vet Sci) - "It is treated with pyrimethamine combined with sulfadiazine or clindamycin, often supplemented with leucovorin, atovaquone, and dexamethasone. gondii vaccine is for sheep, licensed for veterinary use to prevent ovine abortions. In this review, we have summarized the current understanding of toxoplasmosis."

Journal • Review • Infectious Disease

Usefulness and Limitations of Polymerase Chain Reaction (PCR) for the Diagnosis and Management of Toxoplasmosis Following Allogeneic Hematopoietic Cell Transplant: Single-center Experience With 31 Patients Over 16 Years. (PubMed, Open Forum Infect Dis) - "Given the short window between infection and progression to disease, we recommend twice-weekly monitoring with whole blood PCR while off TMP-SMX and early initiation of TMP-SMX post-HCT for Toxoplasma seropositive patients. Atovaquone may be considered as a bridging prophylaxis until TMP-SMX is started, but its absorption may be compromised early post-HCT and breakthrough cases have been reported."

Journal • Polymerase Chain Reaction • Infectious Disease • Transplantation

A Dual In vitro and In silico Approach to Evaluate 1,4-Naphthoquinone-1,2,3-triazole Hybrids Against Atovaquone-Resistant Malaria. (PubMed, Exp Parasitol) - "Furthermore, in silico evaluations of these hybrids suggested good oral bioavailability and high gastrointestinal absorption, with no significant risk of severe toxicity. Hybrids D12 and D13 exhibit potential as lead candidates, with their strong in vitro efficacy well-supported by in silico data, warranting further optimisation and development."

Journal • Preclinical • Infectious Disease • Malaria

Self-Delivery Nanotherapeutics for Tumor Low-Temperature Photothermal Immunotherapy through Cascade Heat Shock Protein and Inflammation Inhibition. (PubMed, ACS Appl Mater Interfaces) - "To address these challenges, we developed a multifunctional immunophotothermal nanoplatform (IAC NPs) through rational engineering of human serum albumin for combinatorial delivery of indocyanine green as a photothermal converter, atovaquone for HSP70-mediated thermoresistance blockade, and celecoxib for COX-2/PGE2 pathway inhibition. In vivo, the IAC NPs mediated profound suppression of both primary tumors and metastatic dissemination while exhibiting optimal biocompatibility for clinical translation. Our work validates a nanoenabled self-delivery system that augments the efficacy of LTPTT immunotherapy against TNBC by orchestrating coordinated inhibition of HSPs and inflammatory responses."

IO biomarker • Journal • Breast Cancer • Oncology • Solid Tumor • Triple Negative Breast Cancer • CD4 • CD8

MSN/STAT3 drives cancer stemness and chemoresistance via IL-6/LPAR1 ligand receptor complex in triple-negative breast cancer. (PubMed, Breast Cancer Res) - "Our findings uncover the critical role of MSN in regulating STAT3-mediated cancer stemness via the IL-6/NF-κB signaling axis. These results provide a strong rationale for repositioning STAT3 inhibitors such as Atovaquone as a therapeutic strategy in Adriamycin-resistant TNBC patients exhibiting pSTAT3-MSN complex upregulation."

Journal • Breast Cancer • Oncology • Solid Tumor • Triple Negative Breast Cancer • CDC42 • IGF1 • IL6 • MSN • STAT3

Panhypopituitarism and Arginine-vasopressin Deficiency in a Case of Toxoplasma Encephalitis Secondary to AIDS (ENDO 2025) - "The patient was started on a 6-week regimen of Atovaquone, Leucovorin, and Pyrimethamine...At 8 weeks post-presentation, he continued to require substitution with desmopressin, at a decreased dose compared to initially, corticosteroids, and levothyroxine... The incidence of toxoplasmic encephalitis (TE) has significantly declined with the advancement of antiretroviral therapy. However, untreated or undiagnosed HIV-positive patients remain at high risk, with up to 30% developing TE. A high clinical suspicion of endocrine deficiencies in such cases is essential for timely diagnosis and treatment."

Clinical • CNS Disorders • Endocrine Disorders • Human Immunodeficiency Virus • Hypotension • Infectious Disease • Ophthalmology • Pneumonia • Respiratory Diseases • CD4 • IGF1

Management of human babesiosis - approaches and perspectives. (PubMed, Expert Rev Anti Infect Ther) - "Most cases of human babesiosis are successfully treated with atovaquone plus azithromycin or clindamycin plus quinine. Two immediate goals are, (i) to develop new antimicrobial agents that target Babesia spp. through novel mechanisms and can overcome resistance to currently recommended antimicrobial agents and, (ii) to gain a better understanding of the efficacy of red blood cell exchange transfusion and indications for its use."

Journal • Review

Oxygen-Enhanced Multispectral Optoacoustic Tomography for Assessment of Atovaquone-Mediated Hypoxia Alleviation in Pediatric Tumors (SNMMI 2025) - "The EC50 of AVO was 18.2 ± 3.8 µM and 28.6 ± 8.3 µM in D425 and A-204 respectively (Figure 1A). OCR measurements in A-204 cells showed that AVO effectively inhibited oxidative phosphorylation (OXPHOS) near the EC50 (Figure 1B). OE-MSOT effectively traced spatiotemporal changes in tumor oxygen saturation (ΔsO2)."

Clinical • Brain Cancer • Medulloblastoma • Oncology • Pediatrics • Solid Tumor

Oxygen-Enhanced Multispectral Optoacoustic Tomography for Assessment of Atovaquone-Mediated Hypoxia Alleviation in Pediatric Tumors (SNMMI 2025) - "The EC50 of AVO was 18.2 ± 3.8 µM and 28.6 ± 8.3 µM in D425 and A-204 respectively (Figure 1A). OCR measurements in A-204 cells showed that AVO effectively inhibited oxidative phosphorylation (OXPHOS) near the EC50 (Figure 1B). OE-MSOT effectively traced spatiotemporal changes in tumor oxygen saturation (ΔsO2)."

Clinical • Brain Cancer • Medulloblastoma • Oncology • Pediatrics • Solid Tumor

Pneumocystis pneumonia in a patient receiving nab-paclitaxel plus gemcitabine for unresectable pancreatic cancer: A case report. (PubMed, Intern Med) - "We herein report the first case of pneumocystis pneumonia (PCP) in a 78-year-old man with unresectable pancreatic head cancer who was treated with nab-paclitaxel plus gemcitabine. After treatment with corticosteroids and trimethoprim/sulfamethoxazole, the patient's general condition improved, followed by atovaquone. The administration of corticosteroids to prevent chemotherapy-induced nausea and vomiting (CINV) and lymphocytopenia due to chemotherapy may be therefore involved in the development of PCP."

Journal • Chemotherapy-Induced Nausea and Vomiting • Hematological Disorders • Infectious Disease • Oncology • Pancreatic Cancer • Pneumonia • Respiratory Diseases • Solid Tumor

Efficacy and mechanism of action of cipargamin as an antibabesial drug candidate. (PubMed, Elife) - "Resistant strains showed no significant cross-resistance to atovaquone or tafenoquine succinate (TQ), with less than a onefold change in IC50 values. Combining CIP with TQ effectively eliminated B. microti infection in SCID mice with no relapse, and parasite DNA was not detected by qPCR within 90 days post-infection. Our findings reveal the efficacy of CIP as an antibabesial agent, its limitations as a monotherapy due to resistance development, and the potential of combination therapy with TQ to overcome said resistance and achieve complete parasite clearance."

Journal • Infectious Disease

From Tick Bite to Broken Heart: A Case of Stress Cardiomyopathy Induced by Severe Babesiosis. (PubMed, Cureus) - "Despite treatment with atovaquone and azithromycin, her clinical status deteriorated, necessitating exchange transfusion, mechanical ventilation for respiratory failure, and hemodynamic support with inotropes and vasopressors for refractory cardiogenic shock. Echocardiography confirmed Takotsubo cardiomyopathy, which resolved with appropriate treatment. This case underscores the diagnostic complexity and potential severity of babesiosis, highlighting the importance of maintaining a high index of suspicion and initiating prompt therapy to prevent serious complications."

Journal • Cardiomyopathy • Cardiovascular • Fatigue • Hematological Disorders • Infectious Disease • Lyme Disease • Respiratory Diseases

Anti-Parasitic Activity of Azaindole Compounds on Babesia duncani, a Causative Agent of Human Babesiosis (ASM Microbe 2025) - "Building upon these results,synergistic testing of compound 18 with atovaquone, azithromycin, clindamycin, and quininerevealed enhanced anti-parasitic effects in certain combinations. These findings provide a basisfor further exploration of azaindole-based therapies in combating babesiosis.Keywords: Babesiaduncani, babesiosis, azaindole, anti-parasitic compounds, novel therapies"

Infectious Disease • Malaria

Clinically applicable parasite viability assay for rapid assessment of antimalarial pharmacodynamic endpoints. (PubMed, Antimicrob Agents Chemother) - "In this study, the accuracy of direct viability assessment (DVA) of the parasite using MT staining was compared with the previously established PRR assay to evaluate the efficacy of four reference antimalarial drugs (dihydroartemisinin, chloroquine, atovaquone, and pyrimethamine) using P. falciparum 3D7 strain. In conclusion, the DVA relies on specialized equipment and technical expertise. However, it can emerge as an alternative to the PRR, offering a faster and more clinically suited approach for studies."

Journal • PK/PD data • Infectious Disease • Malaria

A propidium iodide-based in vitro screen of the "Bug Box" against Babesia duncani reveals potent inhibitors. (PubMed, Antimicrob Agents Chemother) - "A screen of the 41-compound library Structural Genomics Consortium Bug Box was conducted, yielding five hits: trimethoprim, atovaquone, SDDC M7, diphenyleneiodonium chloride, and panobinostat. Dose-response testing of structurally related compounds revealed multiple potential leads, including nanatinostat and quisinostat, both of which were potent at the nanomolar level and showed favorable selectivity index in cytotoxicity studies. High-throughput screening using PI and 384-well plates is an advance in drug discovery for babesiosis, and HDAC inhibitors show promise as lead compounds worthy of further investigation."

Journal • Preclinical • Infectious Disease

Risk Factors for Pneumocystis jirovecii Pneumonia in Rheumatoid Arthritis: The Protective Potential of Salazosulfapyridine. (PubMed, Int J Rheum Dis) - "Patients with RA complicated by interstitial pneumonia are at a higher risk of developing PCP. Although methotrexate and b/tsDMARDs do not increase the risk of developing PCP, SASP may potentially reduce the risk. A prospective study is warranted to investigate the efficacy and safety of SASP in patients with RA at high risk for PCP."

Journal • Retrospective data • Immunology • Infectious Disease • Inflammatory Arthritis • Interstitial Lung Disease • Pneumonia • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology

Enhancing Adherence to Prophylaxis and Pre-Administration Screening Protocols for Rituximab Infusions in the Renal Assessment Unit ( RAU) (UKKW 2025) - "We prescribe antibiotic prophylaxis with co-trimoxazole or atovaquone to prevent the risk of pneumocystis Jirovecii pneumonia infection. Targeted simple interventions, which included implementing the pre-infusion checklist and educating the multidisciplinary team, including prescribers, nursing staff, and pharmacists, initially resulted in significant improvement. However, this was not sustained. This has highlighted the need for ongoing regular education and training, which have now been implemented."

Adherence • Clinical • Glomerulonephritis • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Lupus Nephritis • Nephrology • Pneumonia • Respiratory Diseases • Tuberculosis

The Thienopyrimidinone Gamhépathiopine Targets the QO Site of Plasmodium falciparum Cytochrome b. (PubMed, ACS Infect Dis) - "Cross-resistance profiling and docking studies indicate that gamhépathiopine occupies a similar, but not identical, binding pose to the established QO-targeting antimalarial atovaquone. The implications of these findings for the future development of gamhépathiopine are discussed."

Journal • Infectious Disease • Malaria