atovaquone / Generic mfg. - LARVOL DELTA

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

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

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

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

Babesiosis-Induced Hemophagocytic Lymphohistiocytosis Following Spontaneous Splenic Rupture in a Florida Resident: A Case Report. (PubMed, Cureus) - "The patient responded well to atovaquone and azithromycin, with complete resolution of HLH symptoms and laboratory abnormalities. This case highlights the necessity for clinical vigilance, the integration of travel history into diagnostic evaluations, and the potential for fatal outcomes if babesiosis-induced HLH is not promptly diagnosed and treated. Increased awareness and training for clinicians in non-endemic regions, as well as public health measures, are essential to improving outcomes."

Journal • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Immunology • Infectious Disease • Rare Diseases • Septic Shock • Thrombocytopenia

Identifying antimalarials that disrupt malaria parasite transmission when fed to the mosquito. (PubMed, Int J Parasitol) - "Azithromycin, an antibiotic targeting apicoplast protein synthesis, significantly lowered sporozoite infectivity in mice. T111, a next generation compound targeting the parasite electron transport chain, reduced sporozoite numbers in P. berghei at equivalent concentrations to the gold standard electron transport chain inhibitor, atovaquone...Our findings suggest that several antimalarials can be used to target mosquito-stage parasites via sugar baits and limit malaria transmission. Importantly, mosquito feeding of antimalarials could vastly increase the range of potentially useful parasiticidal compounds to include those failing to meet the exacting standards required for human antimalarial drugs, potentially improving malaria control for minimal cost."

Journal • Infectious Disease • Malaria

Developing Novel Therapies Against Endometriosis Through Inhibition of Oxidative Phosphorylation (WCE 2025) - "Atovaquone is extensively used to treat malaria in humans and is therefore an excellent agent to consider for the treatment of endometriosis. The metabolic adaptations by the OXPHOS inhibitor-treated endometriotic cells may provide additional targets for drug development."

Endometriosis • Gynecology • Infectious Disease • Malaria • Women's Health

Inner-mitochondrial membrane protein PfMPV17 is linked to P. falciparum in vitro resistance to the indoloquinolizidine alkaloid alstonine. (PubMed, J Antimicrob Chemother) - "These data demonstrate that PfMPV17 is linked to alstonine resistance and suggest that alstonine action is linked to the mitochondria and/or pyrimidine biosynthesis pathways."

Journal • Preclinical • Infectious Disease • Malaria

Cohabitating in the City: A Case of Hemolytic Anemia in a Patient Coinfected With Babesiosis, Lyme Disease, and Mononucleosis. (PubMed, Cureus) - "Treatment with doxycycline and valganciclovir was started, as IgM antibodies were positive for Lyme disease and cytomegalovirus (CMV). Due to worsening symptoms and clinical deterioration, the treatment was broadened with azithromycin and atovaquone, after which the patient experienced significant clinical and paraclinical improvement. Further studies revealed active babesiosis and EBV infection, besides a negative CMV viral load, indicating a false-positive initial result. After finishing treatment for babesiosis and Lyme disease, the patient recovered completely and remains asymptomatic to this day. Diagnosing active babesiosis, Lyme, and EBV coinfection was challenging because of the absence of erythema migrans, lack of apparent tick exposure history, and concerns for cross-reactivity. To the best of our knowledge, this is one of the first cases of coinfection among these three pathogens reported in medical literature."

Journal • Anemia • Autoimmune Hemolytic Anemia • Cytomegalovirus Infection • Dermatology • Epstein-Barr Virus Infections • Fatigue • Hematological Disorders • Immunology • Infectious Disease • Inflammatory Arthritis • Lyme Disease • Musculoskeletal Pain • Pain • Rheumatology

Ex Vivo Drug Susceptibility of Plasmodium malariae Isolates to Antimalarial Drugs in Gabon. (PubMed, Pathogens) - "The mean concentrations required to inhibit 50% of growth (IC50) with chloroquine (n = 21), artesunate (n = 20), atovaquone (n = 21), and lumefantrine (n = 14) were 7.2 nM, 2.7 nM, 3.1 nM, and 7.4 nM, respectively. Our study provides novel data on the ex vivo susceptibility of P. malariae to several key antimalarials, including the first dataset for atovaquone."

Journal • Preclinical • Infectious Disease • Malaria

Leptospira(ls) to Pulmonary Hemorrhage (ATS 2025) - "The patient was started on doxycycline, atovaquone, and azithromycin for concern of tickborne illness...Given the severity of his disease and initial lack of improvement, the patient was administered ceftriaxone, while continuing doxycycline...Initially, bronchoscopy was considered, however, given that the patient improved clinically with antibiotic therapy, it was deferred. Our patient was fortunate to have complete recovery with appropriate therapies, as leptospirosis presenting with DAH carries a mortality rate of >70%.2 This case demonstrates the importance of considering leptospirosis amongst the differential diagnoses for pulmonary hemorrhage, regardless of exposure endorsement."

Acute Kidney Injury • Back Pain • Barrett Esophagus • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Infectious Disease • Musculoskeletal Pain • Pain • Renal Disease • Thrombocytopenia

Splenic Infarction in Babesiosis: What Happens in the Caribbean Should Stay in the Caribbean (ATS 2025) - "Babesia species infection was confirmed with PCR, prompting initiation of azithromycin and atovaquone...At this time, doxycycline was empirically added, although he eventually tested negative for all other tick-borne illnesses...Interestingly, 42% of the 34 cases of splenic complications did not report abdominal pain, which is consistent with the painless presentation of our patient. The low incidence of splenic complications, a lack of correlation between parasitemia level and splenic injury, and the inconsistent manifestation of abdominal pain in these patients should highlight the need to maintain a high level of suspicion and the need to obtain abdominal imaging in a patient with Babesiosis who becomes clinically unstable."

Acute Kidney Injury • Cardiomyopathy • Cardiovascular • Diabetes • Fatigue • Genito-urinary Cancer • Hepatology • Infectious Disease • Metabolic Disorders • Nephrology • Pain • Prostate Cancer • Renal Disease • Septic Shock • Solid Tumor

A Case of Acute Liver Failure Secondary to Profound Babesia in a Patient With No Known Liver Disease (ATS 2025) - "He was started on atovaquone, azithromycin, and doxycycline, and transferred to a tertiary care center for consideration of exchange transfusion given his significant parasite burden and clinical deterioration. Infections in immunocompetent hosts are rare and only a handful of case reports with kidney and liver failure exist. As these infections increase, further familiarity and understanding of those with severe disease is necessary."

Clinical • Anemia • Fibrosis • Heart Failure • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Liver Failure • Pain

Hemophagocytic Lymphohistiocytosis (HLH) Triggered by a Tick Bite in a Patient With Undiagnosed T-cell Lymphoma (ATS 2025) - "She was started on atovaquone and azithromycin for possible babesiosis and doxycycline for ehrlichiosis. A few days after her death, a Karius test returned positive for Ehrlichia chaffeensis, confirming the final diagnosis of HLH secondary to Ehrlichiosis in the setting of previously undiagnosed T-cell lymphoma.DiscussionCompared to other triggers, HLH associated with lymphoma have worse prognosis than those associated with infection or malignancy.2 This case illustrates the complexity of HLH when triggered by both an infectious agent, Ehrlichiosis, and undiagnosed malignancy. Nonetheless, this highlights the importance of having a high clinical suspicion for HLH and consideration of co-infection with tick-borne illness in patient from endemic areas to guide appropriate and timely treatment."

Clinical • Atypical Hemolytic Uremic Syndrome • Cardiovascular • CNS Disorders • Dyslipidemia • Hematological Disorders • Hematological Malignancies • Hemophagocytic lymphohistiocytosis • Hypertension • Hypertriglyceridemia • Immunology • Infectious Disease • Lymphoma • Musculoskeletal Pain • Nephrology • Oncology • Pain • Rare Diseases • Renal Disease • Sjogren's Syndrome • T Cell Non-Hodgkin Lymphoma • Thrombocytopenia • Thrombocytopenic Purpura • TNFRSF8

Pulmonary Cavitary Sarcoidosis (ATS 2025) - "The patient was started on prednisone as well as atovaquone for Pneumocystis jirovecii pneumonia prophylaxis and referred to pulmonology for follow up. In areas where tuberculosis presence is high, cavitary sarcoidosis may be misdiagnosed. Though rare, cavitary lung lesions can be a radiographic feature of sarcoidosis and their presence warrants its consideration in the differential diagnosis."

Anemia • Fatigue • Hematological Disorders • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Pneumonia • Respiratory Diseases • Sarcoidosis • Tuberculosis

A Missed Origin of Diffuse Pulmonary Cysts (ATS 2025) - "She was started with Atovaquone for PCP prophylaxis...SS has a higher risk of developing B-cell lymphoproliferative disorders, mainly non-Hodgkin lymphomas. This case illustrates the importance of ruling out concomitant autoimmune conditions in a patient with diffuse lung cystic lesions diagnosed to be DLBCL."

Acute Kidney Injury • Anemia • B Cell Lymphoma • Cardiomyopathy • Cardiovascular • Cough • Diabetes • Diabetic Nephropathy • Diffuse Large B Cell Lymphoma • Glomerulonephritis • Hematological Disorders • Hematological Malignancies • Human Immunodeficiency Virus • Hypertension • Hypotension • Immunology • Infectious Disease • Inflammatory Arthritis • Lupus • Lupus Nephritis • Lymphoma • Metabolic Disorders • Nephrology • Neutropenia • Non-Hodgkin’s Lymphoma • Oncology • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • Sjogren's Syndrome • Systemic Lupus Erythematosus • CD4

From Chest to Toe: A Case of Disseminated Coccidioidomycosis Immediately Post Renal Transplant (ATS 2025) - "She reported strict adherence to the prescribed immunosuppressant regimen (mycophenolate, tacrolimus, prednisone) and post-transplant infectious prophylaxis (atovaquone, fluconazole, and valganciclovir)...She was empirically treated with piperacillin-tazobactam and remained on prophylactic atovaquone and valganciclovir while awaiting serologic and sputum studies, including expectorated MTB-PCR...On day four, a positive 1,3-beta-D-glucan prompted the initiation of posaconazole...She was started on IV liposomal amphotericin B after blood and right hallux vesicle cultures confirmed fungemia and cutaneous involvement...She was discharged home on a prolonged course of voriconazole for disseminated coccidioidomycosis, with ongoing symptomatic and radiographic improvement...Donor-derived Coccidioides typically presents within one month of transplant with severe infection and carries a mortality rate nearing 30%. Although routine fungal prophylaxis has reduced the incidence of..."

Clinical • Cough • Dermatology • Glomerulonephritis • IgA Nephropathy • Infectious Disease • Nephrology • Pain • Renal Disease • Respiratory Diseases • Solid Organ Transplantation • Transplantation • Tuberculosis

IRIS After PCP: The Inflammation Nobody Wants (ATS 2025) - "Treatment with Bactrim and prednisone was initiated according to PCP guidelines...Bactrim was subsequently switched to Atovaquone, leading to a significant decrease in the potassium level. In addition, the patient was started on Biktarvy and azithromycin for Mycobacterium avium complex prophylaxis, with a CD4 count of 54 cells/µL...To minimize this risk, it's vital to start ART early, before CD4 cell counts decline, and identify as well as treat any existing or prior infections before starting ART. Early recognition and management of IRIS are crucial to prevent serious complications and improve patient outcomes."

Acute Respiratory Distress Syndrome • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Obstructive Sleep Apnea • Pneumonia • Pulmonary Disease • Respiratory Diseases • Sleep Disorder • CD4

Nocardia Veterana Lung Cavitary Lesion Masquerading as Pneumocystis Pneumonia Cavitation (ATS 2025) - "Case: A 77-year-old male with ulcerative colitis and melanoma, being treated with nivolumab, was admitted due to diarrhea and was endoscopically found to have colitis with concerns it was nivolumab-induced. The patient was started on intravenous methylprednisolone and switched over to an oral prednisone taper before being discharged...Thus, infliximab was started along with the prednisone. The patient was prescribed prophylactic atovaquone but had only started using it approximately 2 weeks from the first steroid dose usage...Since studies revealed sensitivity to TMP-SMX, the patient was kept on it for treatment...Given its slow growth on culture, it may be initially managed by treatment for other contaminating or co-present organisms such as pneumocystis. Therefore, Nocardia should always be in the differential in the immunocompromised population."

Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammatory Bowel Disease • Melanoma • Oncology • Pneumonia • Respiratory Diseases • Solid Tumor • Ulcerative Colitis

Diffuse Alveolar Hemorrhage in Hydralazine Induced Vasculitis With Rapidly Progressive Glomerulonephritis: A Case of Pulmonary Renal Syndrome (ATS 2025) - "The patient was treated with high-dose corticosteroids, atovaquone 1500 mg daily for PCP prophylaxis, and initially rituximab, later changed to cyclophosphamide...The patient received empiric antibiotic coverage with vancomycin, cefepime, and doxycycline...Differentiating hydralazine-induced ANCA vasculitis from similar conditions, such as hydralazine-induced lupus (HIL) and idiopathic ANCA-associated vasculitis, relies on clinical presentation, antibody profiles, and kidney biopsy findings. HIL typically involves systemic symptoms and is rare in kidney involvement, while ANCA vasculitis commonly affects the kidneys, often showing pauci-immune crescentic glomerulonephritis on biopsy."

Clinical • ANCA Vasculitis • Anorexia • Cardiovascular • Fibrosis • Glomerulonephritis • Hematological Disorders • Hypertension • Inflammation • Inflammatory Arthritis • Lupus Nephritis • Nephrology • Pain • Renal Disease • Respiratory Diseases • Vasculitis

Atovaquone Inhibits ABCC1 and Decreases Camp Egress in Human Airway Smooth Muscle Cells (ATS 2025) - "This abstract is funded by: NIH, National Heart, Lung, and Blood Institute grant P01HL114471, R01HL164404 RATIONALE: Evidence suggests that atovaquone and mefloquine, anti-malarial drugs, modulate the activity of ATP-binding cassette (ABC) transport proteins. Atovaquone inhibits ABCC1 activity in HASM cells, offering a new approach to repurpose anti-malaria drugs to enhance cAMP signaling and PKA-dependent HASM relaxation in the treatment of airflow obstruction in asthma."

Asthma • Immunology • Infectious Disease • Malaria • Respiratory Diseases • ABCC1

FROM QUIET PASSENGER TO ACTIVE SABOTEUR: A POST-TRANSPLANT STORY. (ESPID 2025) - "Given its potential myelosuppressive side effect, suppressive treatment was held and substituted by azithromycin...He improved following re-starting Pyrimethamine and Sulfadiazine, however developed residual dysarthria and hemiparesis...Prophylaxis with trimethoprim-sulfamethoxazole is recommended, however can be contraindicated in patients at risk of myelosuppression, for which cases local protocol now recommends Atovaquone as preferred agent. Breakthrough toxoplasmosis disease can still occur."

Post-transplantation • Infectious Disease

Image-guided targeting of mitochondrial metabolism sensitizes pediatric malignant rhabdoid tumors to low-dose radiotherapy. (PubMed, Sci Adv) - "Our transcriptomics and bioenergetic profiling data reveal that mitochondrial oxidative phosphorylation is a metabolic vulnerability of MRT and can be exploited to overcome consumptive hypoxia by repurposing an FDA-approved antimalarial drug, atovaquone (AVO)...Last, we use translational mathematical modeling for systematic evaluation of dosing regimens, administration timing, and therapeutic synergy in a virtual patient cohort. Together, our work establishes a framework for safe and pediatric patient-friendly image-guided metabolic radiosensitization of rhabdoid tumors."

Journal • Infectious Disease • Oncology • Pediatrics • Rhabdoid Tumor • Sarcoma

Premature Discontinuation of Trimethoprim/Sulfamethoxazole Prophylaxis in Abdominal Transplant Recipients: A Deeper Dive. (PubMed, Transpl Infect Dis) - "Alternative prophylaxis included pentamidine (43%), none (30%), dapsone (22%), and atovaquone (5%). TMP/SMX is often discontinued prematurely in SOT recipients without resumption despite resolution of the offending cause. TMP/SMX prophylaxis should be maintained where possible, as alternative therapy may not offer the same broad spectrum of protection against OI."

Journal • Hematological Disorders • Infectious Disease • Pneumonia • Respiratory Diseases • Solid Organ Transplantation • Transplantation