atovaquone / Generic mfg. - LARVOL DELTA

Myasthenia Gravis (MG) Crisis, A Rare Immune-Related Adverse Event (irAE) of Dostarlimab (SCCM 2026) - "She received IV immunoglobulins (IVIG) , oral pyridostigmine, and IV methylprednisolone...She had the classic triad of MG, myositis, and myocarditis as an emerging ICI toxicity, received high- dose steroid, transitioned to prednisone with taper, and received atovaquone for prophylaxis...Current IVIG and rituximab guidelines recommend against initiating plasmapheresis shortly after administering rituximab; however, literature on the optimal sequence and timing is limited. Early recognition will change the management plan so IVIG and high-dose steroids can be started as soon as thecondition is recognized."

Adverse events • Cardiovascular • CNS Disorders • Endometrial Cancer • Immunology • Myasthenia Gravis • Myositis • Pulmonary Disease • Respiratory Diseases • Solid Tumor • Uterine Cancer

Afebrile but Infected: Severe Babesiosis Requiring Exchange Transfusion in an Elderly Patient (SCCM 2026) - "Treatment with atovaquone, azithromycin, and RBC exchange was immediately initiated with post-procedure parasitemia of 2.9%. Workup for babesiosis should not be delayed in afebrile patients with hemolytic anemia, thrombocytopenia, transaminitis, and any travel to endemic areas despite lack of confirmed tick exposure. In cases with high-grade parasitemia and shock, exchange transfusion should be considered."

Clinical • Acute Kidney Injury • Anorexia • Cardiovascular • CNS Disorders • Congestive Heart Failure • Geriatric Disorders • Heart Failure • Hematological Disorders • Hepatology • Nephrology • Pulmonary Disease • Renal Disease • Thrombocytopenia • Thrombocytopenic Purpura

Acute Respiratory Distress Syndrome Meets Methemoglobinemia: Hypoxemic Challenges in Pneumocystis (SCCM 2026) - "Due to TMP-SMX allergy, the patient was given Clindamycin-Primaquine with prednisone...Her methemoglobin level was 21.4%, so Clindamycin-Primaquine was transitioned to Atovaquone, and she was given methylene blue after ruling out glucose-6-phosphate dehydrogenase (G6PD) deficiency...In patients without a history of anaphylaxis, a One-step full-dose TMP-SMX challenge should be individualized and may prevent complications, such as primaquine-induced methemoglobinemia. In methemoglobinemia, the conformational change in the quadrivalent hemoglobin unit causes impaired oxygen offloading capacity, shifting the oxygen-dissociation curve to the left and worsening hypoxemia."

Acute Respiratory Distress Syndrome • Cardiovascular • Hematological Disorders • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Metabolic Disorders • Pneumonia • Respiratory Diseases • Thrombosis • CD4

Acute Liver Failure in Adult-Onset Still Disease: A Diagnostic Challenge (SCCM 2026) - "Although hepatic involvement typically presents as mildly elevated transaminases, in rare cases, it can progress to acute liver failure.Description: 48-year-old female with a new diagnosis of AOSD on high dose prednisone and Bactrim for PJP prophylaxis, presented to the ER with a 3-day history of nausea, vomiting, and abdominal pain...Patient was started on IV N-acetylcysteine, corticosteroids, and atovaquone...After clinical stabilization, patient was discharged with a tapering course of prednisone and continued on atovaquone. This case highlights the challenge of managing acute liver injury in the context of AOSD, which may result from disease itself, AOSD-induced macrophage activation syndrome, or DILI. High clinical suspicion, timely escalation of care to a liver transplant center and a multidisciplinary approach are critical in ensuring a favorable clinical outcome."

Clinical • Autoimmune Hepatitis • Gastroenterology • Gastrointestinal Disorder • Hemophagocytic lymphohistiocytosis • Hepatology • Immunology • Inflammation • Liver Failure • Rare Diseases

Evaluation of Pneumocystis jirovecii (PJP) and Cytomegalovirus (CMV) Prophylaxis Duration in Kidney Transplant Recipients (UKKW 2026) - "Valganciclovir is also administered to patients receiving alemtuzumab (Campath) induction immunosuppression, unless both donor and recipient are CMV- negative...57 patients were identified as having been started on co-trimoxazole/atovaquone, and 17 patients on valganciclovir, using a data collection tool developed by the Leicester Kidney Pharmacy Team... Of the 57 patients on PJP prophylaxis, 13 (23%) continued treatment beyond the 6 month period. Similarly, 6 out of 17 patients (35%) prescribed valganciclovir extended beyond the recommended duration. No documented clinical reasons justified these prolonged courses."

Clinical • Cytomegalovirus Infection • Immunology • Infectious Disease • Pneumonia • Respiratory Diseases • Transplant Rejection • Transplantation

TOXOPLASMOSIS SCREENING, PROPHYLAXIS AND TREATMENT PRACTICES ACROSS EBMT CENTERS: A SURVEY ON BEHALF OF THE INFECTIOUS DISEASES WORKING PARTY (EBMT 2026) - "If trimethoprim-sulfamethoxazole is contraindicated, most employed alternatives are atovaquone ± pyrimethamine (45/126, 36%) or nothing (27/126, 21%).In asymptomatic patients, anti-toxoplasma therapy is initiated after a single positive blood PCR in 19/67 (28%) centers, in 2/67 (3%) only if the patient is considered high-risk, in 7/67 (10%) only if the PCR-value is very high...Specific assessments are variably performed: cerebral MRI (49/67, 73%), lung CT (42/67, 63%), ophthalmic examination (43/67, 64%), lumbar puncture (20/67, 30%) and bone marrow assessment (10/67; 15%).Anti-toxoplasma therapy relies on trimethoprim-sulfamethoxazole, pyrimethamine-sulfadiazine and pyrimethamine-clindamycin with similar distribution for infection (73/134, 54%; 49/134, 37%; 10/134, 7%) and disease (66/132, 50%; 54/132, 41%; 9/132, 7%)... This survey highlights significant variability across EBMT centers in toxoplasmosis management, underscoring the need for ongoing harmonization,..."

Bone Marrow Transplantation • Infectious Disease • Ophthalmology • CD4

A Case of Disseminated Nocardiosis in a Heart Transplant Recipient (ISHLT 2026) - "He was induced with basiliximab (BAS) as a renal sparing strategy and maintained on tacrolimus, mycophenolate, and prednisone. OIP consisted of nystatin, valganciclovir, and atovaquone in lieu of TMP-SMX due to renal function...A CT chest identified nodular infiltrates concerning for disseminated infection, and empiric therapy was initiated with linezolid (LZD), imipenem-cilastatin, and TMP-SMX. TMP-SMX was later replaced with ciprofloxacin (CIP) due to AKI on CKD. The organism was subsequently identified as Nocardia pseudobrasiliensis and his antibiotic regimen was de-escalated to LZD and CIP based on susceptibilities with a planned duration of 6 months.Summary Studies have established that TMP-SMX is superior in preventing OI when compared to alternative agents such as atovaquone; furthermore, the incidence of Nocardiosis increases significantly in immunocompromised patients who are not on TMP-SMX. With implementation of the OPTN safety net program for kidney after..."

Clinical • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • Chronic Obstructive Pulmonary Disease • Immunology • Infectious Disease • Respiratory Diseases • Spindle Cell Sarcoma • Transplantation

Unmasking an Atypical Presentation of Primary PLA2R-Positive Membranous Nephropathy With Superimposed Acute Interstitial Nephritis and Monoclonal Gammopathy (NKF-SCM 2026) - "He received intravenous methylprednisolone followed by oral prednisone, with gradual improvement in renal function without dialysis...Cyclophosphamide was initiated for maintenance therapy along with atovaquone prophylaxis...The IgM gamma clone raises concern for MGRS, which can produce varied renal lesions. CONCLUSION The coexistence of MN, AIN, and monoclonal gammopathy reflects complex renal mechanisms and requires comprehensive evaluation and coordinated care."

Chronic Kidney Disease • Fibrosis • Genito-urinary Cancer • Glomerulonephritis • Hematological Malignancies • Hypertension • Immunology • Indolent Lymphoma • Lymphoma • Monoclonal Gammopathy • Nephrology • Prostate Cancer • Renal Disease • Solid Tumor

DNAJB9-positive crescentic fibrillary glomerulonephritis with full-house IF: dialysis- dependent AKI and patient-directed deferral of cyclophosphamide (NKF-SCM 2026) - "Crescentic cases with full-house IF can mimic lupus or hydralazine-associated GN, complicating early immunosuppression...Therapy included IV methylprednisolone followed by prednisone 20 mg daily with atovaquone prophylaxis...Respiratory failure improved with hemodialysis. CONCLUSION DNAJB9-positive crescentic FGN can present with dialysis-dependent AKI and full-house IF despite lupus-like serology."

Clinical • Chronic Obstructive Pulmonary Disease • Fibrosis • Glomerulonephritis • Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Pulmonary Disease • Renal Disease • Respiratory Diseases • Sarcoidosis

Acute Kidney Injury and Membranoproliferative Glomerulonephritis in a Patient with Severe Babesiosis (NKF-SCM 2026) - "The patient received atovaquone, azithromycin, and red cell exchange, resulting in parasite clearance and rapid improvement. CONCLUSION These findings strengthen the biologic plausibility that Babesia can trigger complement-mediated glomerular injury in humans unrelated to hemolysis. This case underscores the need for clinicians to consider glomerular pathology when evaluating severe babesiosis with unexplained proteinuria or AKI."

Clinical • Acute Kidney Injury • Glomerulonephritis • Hematological Disorders • Infectious Disease • Lupus Nephritis • Nephrology • Renal Disease • Thrombocytopenia

Acute Hyponatremia and Neuropsychiatric Changes Associated With Atovaquone Use (ATS 2026) - No abstract available

Cardiovascular • Heart Failure • Psychiatry

Response of mid-lactation primiparous Holstein cows to the supplementation of rumen-protected methionine during the summer. (PubMed, PLoS One) - "Cows were blocked by milk yield and DIM and assigned to a control diet (CON; no added RPM) or the same diet supplemented with RPM (Mepron®, Evonik) at 0.75 g/kg diet dry matter, targeting 20 g/cow/day (product contains 62% metabolizable methionine) to the average cow...Mean vaginal temperature did not differ between treatments; however, a treatment × time × hour interaction was observed. Supplementation with RPM improved milk and solids yield, and enhanced antioxidant capacity and insulin levels, supporting its use to improve metabolic resilience under warm conditions."

Journal • Inflammation

Dual function of mitochondrial complex III in Plasmodium falciparum. (PubMed, PLoS One) - "MPPα knockdown also resulted in hypersensitivity of the parasites to proguanil, a drug that synergizes with mtETC inhibitors such as atovaquone. Pulldown with MPPα followed by proteomics revealed the association of multiple mitochondrially targeted proteins, in addition to all components of Complex III. These results are consistent with the suggestion that Complex III in P. falciparum serves both mtETC and protein processing functions in mitochondrial physiology."

Journal • Immunology • Infectious Disease • Malaria

Plasmodium falciparum field isolates drug susceptibility in Mali. (PubMed, JAC Antimicrob Resist) - "Parasites were exposed to 14 drugs, including tafenoquine, N-desethyl-amodiaquine, chloroquine, dihydroartemisinin, lumefantrine, pyronaridine, quinine, sulfadoxine, pyrimethamine, amodiaquine, atovaquone, GNF179, KDU691 and cabamiquine. While current frontline therapies remain effective, reduced activity of chemopreventive antimalarials supports the need for continued surveillance to detect early signs of resistance in Mali. The potent activity of next-generation candidates (cabamiquine and GNF179) supports their potential for further clinical development and field deployment."

Journal • Infectious Disease • Malaria

Atovaquone/proguanil use and zoster vaccination are associated with reduced Alzheimer's disease risk in two cohorts: implications for a latent Toxoplasma gondii mechanism. (PubMed, Brain Behav Immun) - "In exploratory analyses, the magnitude of the association between atovaquone-proguanil and subsequent dementia appeared to differ according to prior VZV vaccination status, suggesting a possible interaction between protozoal suppression and antiviral immunity. Together, these findings provide population-level evidence consistent with a latent T. gondii-related mechanism in AD pathogenesis, and highlight testable targets for future mechanistic and interventional research."

Journal • Alzheimer's Disease • CNS Disorders • Dementia • Herpes Zoster • Varicella Zoster

Hypoxia Alleviation-Potentiated Chemotherapy Enhances Anti-PD-L1 Treatment for Triple-Negative Breast Cancer via Improving Tumor Immunogenicity and Inhibiting STAT3 Activation. (PubMed, ACS Appl Mater Interfaces) - "The combination of anti-PD-L1 and paclitaxel (PTX) is a standard-of-care regimen for triple-negative breast cancer (TNBC)...This project aims to construct an albumin-based nanomedicine coloaded with atovaquone (ATO) and PTX for targeted tumor delivery, thereby enhancing the therapeutic efficacy of ICBs...This transformative approach significantly enhances the therapeutic efficacy of combination chemotherapy, leading to potent suppression of primary tumors while concurrently preventing postoperative recurrence and pulmonary metastases. This project has the potential to introduce innovative strategies and methodologies aimed at overcoming the limited efficacy of PTX combined with ICBs in the treatment of TNBC."

Journal • Breast Cancer • Oncology • Solid Tumor • Triple Negative Breast Cancer • STAT3

ATACC AML: Atovaquone (Mepron®) Combined With Conventional Chemotherapy for de Novo Acute Myeloid Leukemia (AML) (clinicaltrials.gov) - P1 | N=26 | Completed | Sponsor: Baylor College of Medicine | Active, not recruiting ➔ Completed

Trial completion • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Myelodysplastic Syndrome • Oncology

Exploring the prognostic molecular mechanisms of medulloblastoma through methylation-transcriptome integration. (PubMed, SAGE Open Med) - "Drug prediction suggested that atovaquone and embelin may reverse tumor progression. Inhibin beta B and ubiquitin-specific peptidase 2 are key marker genes for predicting medulloblastoma patient prognosis stratification, with their expression patterns closely linked to molecular subtypes and the immune microenvironment. This study provides novel molecular targets and strategies for precision therapy and prognostic assessment in medulloblastoma."

Journal • Brain Cancer • Embryonal Tumor • Medulloblastoma • Oncology • Solid Tumor • Targeted Protein Degradation • INHBB

SPIRIT-ALT: Positioning Second-line Therapies for Pneumocystis Jirovecii Pneumonia (PCP Alternatives) (clinicaltrials.gov) - P4 | N=416 | Not yet recruiting | Sponsor: McGill University Health Centre/Research Institute of the McGill University Health Centre

New P4 trial • Human Immunodeficiency Virus • Infectious Disease • Pneumonia • Respiratory Diseases

Clinical outcomes after switching from sulfamethoxazole-trimethoprim to atovaquone due to intolerance in patients with non-HIV Pneumocystis pneumonia: a single-center retrospective study. (PubMed, J Pharm Health Care Sci) - "Our data suggest that switching from SMX/TMP to Atov may not be associated with worse survival. Long-term administration of SMX/TMP is often challenging due to its side effects, and in this study, more than 30% of patients were unable to tolerate its therapeutic dose. Our findings support the role of Atov as a viable second-line treatment for PCP in immunocompromised patients, such as those with non-HIV PCP."

Clinical data • Journal • Retrospective data • Infectious Disease • Pneumonia • Respiratory Diseases

Integrating machine learning and multi-omics analysis to explore Treg-associated programmed cell death features in clear cell renal cell carcinoma. (PubMed, Cancer Cell Int) - "We explored the significance of Treg and programmed cell death characteristics in the ccRCC tumor microenvironment and established clinically translatable tools for ccRCC diagnosis, prognosis, and personalized therapy selection, thus promoted the application of explainable machine learning models in precision oncology. Furthermore, We have identified SLC11A1 as a highly promising therapeutic target for ccRCC."

IO biomarker • Journal • Clear Cell Renal Cell Carcinoma • Genito-urinary Cancer • Kidney Cancer • Oncology • Renal Cell Carcinoma • Solid Tumor • CASP9 • SLC11A1

Pneumocystis jirovecii pneumonia in a human caused by long-term use of veterinary drug oclacitinib: A case report. (PubMed, IDCases) - "He was initially treated with trimethoprim-sulfamethoxazole and corticosteroids; however, the regimen was switched to atovaquone owing to hepatotoxicity. To our knowledge, this is the first reported case of PJP associated with oclacitinib use in humans. As JAK inhibitors are increasingly being used, clinicians should be aware of their potential to cause opportunistic infections, even with veterinary formulations without approved human indications."

Journal • Atopic Dermatitis • Dermatitis • Dermatology • Immunology • Infectious Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases

Real world treatment outcome with azacytidine (AZA)-tocilizumab (TCZ) for reducing steroid dependence in vexas syndrome with myelodysplastic syndrome (MDS): A single-center, 1.5-year longitudinal observational study (ASH 2025) - "Treatment and outcome: The patient was initiated on high-dose prednisone (PRD) at 40 mg daily and Erythropoiesis-Stimulating Agent, leading to clinical improvement...Acyclovir, atovaquone and voriconazole were used for anti-microbial prophylaxis... As VEXAS syndrome is a novel disease, there is absence of standardized treatment guidelines. This case highlights the promise of AZA-TCZ combination therapy in steroid dependent VEXAS syndrome with MDS. Further investigation into targeted steroid-sparing regimens along with patient specific guidelines is warranted for durable disease control and improved outcomes."

Clinical • HEOR • Observational data • Real-world • Real-world evidence • Eosinophilia • Hematological Disorders • Hematological Malignancies • Inflammation • Leukopenia • Musculoskeletal Diseases • Myelodysplastic Syndrome • Neutropenia • Ocular Inflammation • Ophthalmology • Orthopedics • Renal Disease • Retinal Vein Occlusion • Uveitis

Babesiosis masquerading as ITP in a patient with CLL (ASH 2025) - "Patient's home medications included only ramipril and metoprolol succinate...Patient was started on atovaquone and azithromycin...And patient was diagnosed with Babesiosis. This case highlights how Babesiosis can masquerade as ITP and present as severe thrombocytopenia without any symptoms suggestive of infection."

Clinical • Cardiovascular • Chronic Lymphocytic Leukemia • Coronary Artery Disease • Dyslipidemia • Hematological Disorders • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Thrombocytopenia • HP

Babesia induced cytokine storm: A rare cause of secondary hemophagocytic lymphohistiocytosis (ASH 2025) - "Initially, this was thought to be a tick-borne illness such as anaplasmosis and doxycycline was empirically started...Treatment with Dexamethasone and Etoposide was initiated per HLH-94 guidelines (Henter et al., 2007)...The tick panel was positive for Babesia, and antibiotics were switched to Azithromycin and Atovaquone...Early identification can prevent further spread including CNS spread and prevent the need for hematopoietic stem cell transplants. Screening tools like HScore distinguish hemophagocytic syndromes such as HLH from sepsis or acute hematologic malignancies, allowing for earlier HLH diagnosis and improved outcomes (Fardet et al., 2014)."

Cytokine storm • Bone Marrow Transplantation • Cardiovascular • Coronary Artery Disease • Hematological Malignancies • Hemophagocytic lymphohistiocytosis • Hepatology • Immunology • Infectious Disease • Rare Diseases • Septic Shock • Thrombocytopenia • IL2 • IL2RA