In vitro activity of two phenyl-carbamate derivatives, singly and in combination with albendazole against albendazole-resistant Giardia intestinalis
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Giardia intestinalis is one of the most prevalent parasites in adults and children in Mexico. Benzimidazoles have been proposed as a therapeutic alternative in the treatment of giardiasis. However, high-dose related toxicity and the development of resistance have emerged in clinical trials using this therapy. In the search of alternative drugs, we found that benzimidazole- resistant strains of fungi have shown increased sensitivity to phenyl-carbamates, hence, we developed several substituted phenyl-carbamates, two of which were tested against the protozoan parasite G. intestinalis in susceptible and albendazole-resistant Giardia strains. 4-R-ethyl-phenyl- carbamates IRE-6A and IRE-7B demonstrated antigiardial, albeit modest, activity when compared with albendazole, against susceptible and albendazole-induced resistant Giardia. However, when albendazole 0.38 μg/mL (MIC 50) was combined with each IRE compound, a significant antigiardial synergism (fractional inhibitory concentration index (FICI < 0.5)) was obtained not only with sensitive cultures but also with resistant Giardia parasites. The results described here suggest a potential role for a combined therapy with phenyl-carbamates and sub-doses of benzimidazoles in the treatment of giardiasis. © 2004 Elsevier B.V. All rights reserved.
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Antiparasitic agents; Drug-induced resistant Giardia; Giardiasis; Phenyl-carbamates 4 phenylcarbamate ire 6a; 4 phenylcarbamate ire 7b; albendazole; carbamic acid derivative; unclassified drug; disease treatment; drug resistance; parasitic disease; animal cell; antiprotozoal activity; article; controlled study; drug activity; drug potentiation; Giardia lamblia; giardiasis; microbial sensitivity test; minimum inhibitory concentration; nonhuman; parasite; protozoon; statistical significance; Albendazole; Animals; Antiprotozoal Agents; Carbamates; CHO Cells; Cricetinae; Cricetulus; Dose-Response Relationship, Drug; Drug Resistance; Drug Therapy, Combination; Giardia lamblia; Molecular Structure; Mexico [North America]; North America; Western Hemisphere; World; Fungi; Giardia; Giardia intestinalis; Protozoa
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