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March 1961

The Treatment of Ocular Toxoplasmosis with Spiramycin

Author Affiliations

Wills Eye Hospital and Graduate School of Medicine, University of Pennsylvania, Philadelphia.

Arch Ophthalmol. 1961;65(3):401-409. doi:10.1001/archopht.1961.01840020403014

Introduction  Uveitis of toxoplasmic origin has been treated until the present time by a combination of pyrimethamine (Daraprim) and sulfonamide. At the onset of therapy, elevated doses of pyrimethamine ranging up to 200 mg. on the first day are required in order to reach and maintain effective blood levels1 within a short period. This regimen is often accompanied by headache, nausea, and vomiting which usually subside. However, many patients complain of persistent headache and a general feeling of ill-being. In addition, high doses of bicarbonate are given to keep the urine alkaline and prevent crystallization of the sulfonamide in the renal tubules. The number of tablets to be swallowed and the ensuing side-effects often discourage the patient from scrupulously carrying out the prescribed treatment for 6 to 8 weeks. Therapy is often discontinued because of leukopenia or thrombocytopenia.2 The tendency of steroids to retain water and the necessity

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