bay-44-4400 and Ancylostomiasis

Two exploratory studies were performed to determine the optimum therapeutic dose of Procox(®) for the removal of experimental infection with mature adult Toxocara (T.) cati and Ancylostoma (A.) tubaeforme in kittens. Procox(®) is a new oral suspension containing a combination of the nematocidal and coccidiocidal active principles emodepside (0.1 %) and toltrazuril (2 %).In the first study, 18 eight-weeks-old kittens were inoculated with 450 L3 larvae of T. cati. 56 days after infection, the kittens were allocated to three treatment groups and were treated with 0.5 mg emodepside/kg body weight (group 1), 0.25 mg emodepside/kg body weight (group 2) and 0.1 mg emodepside/kg body weight (group 3), respectively. In the second study, 10 eight-weeks-old kittens were inoculated with 350 L3 larvae of A. tubaeforme. Four weeks after infection, the kittens were allocated to two treatment groups and were treated with 0.1 mg emodepside/kg body weight (group 1) or 0.25 mg emodepside/kg body weight (group 2). In both studies, all kittens received a reference treatment with Drontal(®) (230 mg pyrantel embonate and 20 mg praziquantel per tablet) at the recommended dose of one tablet/4 kg body weight 5 days after treatment with Procox(®). Anthelmintic efficacy was calculated by reduction in worm numbers expelled with the faeces following treatment with Procox(®) as compared with faecal worm numbers after reference treatment with Drontal(®), by thus avoiding necropsy of the animals.In the T. cati study, emodepside was at 99.9 %, 100 % and 96.5 % effective at a dosage of 0.5 mg, 0.25 mg and 0.1 mg per kg body weight, respectively. Against A. tubaeforme emodepside was at 95.7 % and 100 % effective at a dosage of 0.1 mg and 0.25 mg per kg body weight. No adverse events were seen during either study.It can be concluded that Procox(®) is efficacious for the control of mature adult T. cati and A. tubaeforme infections in cats at a single-dose rate of 0.25 mg emodepside/kg body weight.

Topics: Administration, Oral; Ancylostoma; Ancylostomiasis; Animals; Antinematodal Agents; Cat Diseases; Cats; Depsipeptides; Drug Combinations; Drug Evaluation; Larva; Parasite Egg Count; Toxocara; Toxocariasis; Triazines

This paper reports the efficacy of emodepside/praziquantel spot-on (Profender), Bayer AG, Leverkusen, Germany), a novel broad-spectrum anthelmintic for dermal application, against L4 larvae and immature adult and adult stages of Ancylostoma tubaeforme in cats. The formulation contains 2.14% (w/w) emodepside and 8.58% (w/v) praziquantel, with emodepside being active against gastrointestinal nematodes and praziquantel against cestodes. Five randomized, blinded and controlled laboratory studies demonstrated 100% efficacy of emodepside/praziquantel spot-on against mature A. tubaeforme and an efficacy of >95% and >97%, respectively, against L4 larvae and immature adults (based on worm counts after necropsy) at approximately the minimum proposed dose rate in cats of 3.0 mg emodepside and 12.0 mg praziquantel/kg body weight. No adverse reactions to the treatment were observed. It is concluded that emodepside/praziquantel spot-on is an effective and safe treatment against infections with mature and immature A. tubaeforme. Emodepside/praziquantel spot-on will considerably facilitate the treatment of cats against nematodes and cestodes compared with orally administered preparations.

Topics: Administration, Topical; Ancylostoma; Ancylostomiasis; Animals; Anthelmintics; Cat Diseases; Cats; Depsipeptides; Dose-Response Relationship, Drug; Drug Therapy, Combination; Praziquantel

Ancylostoma caninum is the most prevalent intestinal nematode of dogs, and has a zoonotic potential. Multiple-drug resistance (MDR) has been confirmed in a number of A. caninum isolates, including isolate Worthy 4.1F3P, against all anthelmintic drug classes approved for hookworm treatment in dogs in the United States (US). The cyclooctadepsipeptide emodepside is not registered to use in dogs in the US, but in a number of other countries/regions. The objective of this study was to evaluate the efficacy of emodepside + praziquantel, as well as three commercial products that are commonly used in the US for treatment of hookworms, against a suspected (subsequently confirmed) MDR A. caninum isolate Worthy 4.1F3P. 40 dogs infected on study day (SD) 0 with 300 third-stage larvae, were randomly allocated to one of five treatment groups with eight dogs each: pyrantel pamoate (Nemex®-2), fenbendazole (Panacur® C), milbemycin oxime (Interceptor®), emodepside + praziquantel tablets and non-treated control. Fecal egg counts (FEC) were performed on SDs 19, 20, 22, 27, 31 and 34. All treatments were administered as per label requirements on SD 24 to dogs in Groups 1 through 4. Two additional treatments were administered on SDs 25 and 26 to dogs in Group 2 as per label requirements. Dogs were necropsied on SD 34 and the digestive tract was removed/processed for worm recovery and enumeration. The geometric mean (GM) worm counts for the control group was 97.4, and for the pyrantel pamoate, fenbendazole, milbemycin oxime, and emodepside + praziquantel groups were 74.8, 72.0, 88.9, and 0.4, respectively. These yielded efficacies of 23.2%, 26.1%, and 8.8%, and 99.6%, respectively. These data support previous findings of the MDR status of Worthy 4.1F3P as treatments with pyrantel pamoate, fenbendazole and milbemycin oxime lacked efficacy. In sharp contrast, Worthy 4.1F3P was highly susceptible to treatment with emodepside + praziquantel.

Topics: Ancylostomatoidea; Ancylostomiasis; Animals; Anthelmintics; Depsipeptides; Dog Diseases; Dogs; Drug Combinations; Drug Resistance, Multiple; Hookworm Infections; Intestines; Macrolides; Praziquantel; Pyrantel; Treatment Outcome

Ancylostoma ceylanicum is a common zoonotic hookworm of dogs and cats throughout Asia and has also been reported to occur within the Australasian region. The aim of this study to was to determine the efficacy of a spot-on formulation containing emodepside and praziquantel (Profender(®), Bayer) and praziquantel and pyrantel oral tablets (Drontal(®) for Cats, Bayer) against experimental A. ceylanicum infections in cats. Twenty-four kittens were each subcutaneously injected with 100 infective third-stage larvae of A. ceylanicum. Kittens were stratified by egg count and randomly allocated equally into control and two treatment groups. The first group were treated with emodepside 2.1%/praziquantel 8.6% (Profender®, Bayer) at the recommended label dose. The second group was treated with 80 mg pyrantel and 20mg praziquantel (Drontal(®) for Cats, Bayer) at the recommended label dose. The kittens in the control group were not treated. Egg counts were performed daily until the end of the study period and compared for the treated and control groups. No eggs were detected in the treated group of kittens within 4 days of treatment and faecal samples from this group remained negative throughout the rest of the study, resulting in a treatment efficacy (egg reduction) of 100% (P<0.0001). The egg counts remained high (993 ± 666 epg) in the untreated control group for the rest of the study period. This study demonstrated that both combination products containing topical emodepside/praziquantel (Profender(®), Bayer) and praziquantel/pyrantel oral tablets (Drontal(®) for Cats, Bayer) given at the recommended dose is highly effective against infection with A. ceylanicum in cats.

Topics: Ancylostomiasis; Animals; Antinematodal Agents; Cat Diseases; Cats; Depsipeptides; Drug Combinations; Feces; Praziquantel; Pyrantel; Random Allocation; Treatment Outcome

The evolution of drug resistant bacteria is a severe public health problem, both in hospitals and in the community. Currently, some countries aim at concentrating highly specialized services in large hospitals in order to improve patient outcomes. Emergent resistant strains often originate in health care facilities, but it is unknown to what extent hospital size affects resistance evolution and the resulting spillover of hospital-associated pathogens to the community. We used two published datasets from the US and Ireland to investigate the effects of hospital size and controlled for several confounders such as antimicrobial usage, sampling frequency, mortality, disinfection and length of stay. The proportion of patients acquiring both sensitive and resistant infections in a hospital strongly correlated with hospital size. Moreover, we observe the same pattern for both the percentage of resistant infections and the increase of hospital-acquired infections over time. One interpretation of this pattern is that chance effects in small hospitals impede the spread of drug-resistance. To investigate to what extent the size distribution of hospitals can directly affect the prevalence of antibiotic resistance, we use a stochastic epidemiological model describing the spread of drug resistance in a hospital setting as well as the interaction between one or several hospitals and the community. We show that the level of drug resistance typically increases with population size: In small hospitals chance effects cause large fluctuations in pathogen population size or even extinctions, both of which impede the acquisition and spread of drug resistance. Finally, we show that indirect transmission via environmental reservoirs can reduce the effect of hospital size because the slow turnover in the environment can prevent extinction of resistant strains. This implies that reducing environmental transmission is especially important in small hospitals, because such a reduction not only reduces overall transmission but might also facilitate the extinction of resistant strains. Overall, our study shows that the distribution of hospital sizes is a crucial factor for the spread of drug resistance.

Topics: Ancylostoma; Ancylostomiasis; Animals; Anthelmintics; Caenorhabditis elegans; Caenorhabditis elegans Proteins; Depsipeptides; Drug Antagonism; Drug Evaluation, Preclinical; Drug Resistance; Gene Expression Regulation; Haemonchiasis; Haemonchus; Large-Conductance Calcium-Activated Potassium Channels; Motor Activity; Mutation; Mycotoxins; Species Specificity