The potential of drug repurposing: Overcoming translational deadlocks in amoebic encephalitis

Amoebic encephalitis, including primary amoebic meningoencephalitis and granulomatous amoebic encephalitis, remains associated with extremely high mortality and a lack of well-established, safe, and consistently effective therapeutic options. Although numerous novel compounds have demonstrated in vitro and preclinical activity, their translation into clinically reliable treatments has been limited. Here, we argue that de novo drug discovery is poorly aligned with the urgent therapeutic needs imposed by the rarity and fulminant progression of these diseases, which restrict conventional clinical trial development. We propose drug repurposing as a pragmatic and time-efficient strategy to accelerate access to potential therapies. By leveraging existing pharmacological and safety knowledge, repurposing may reduce translational barriers. We discuss key challenges, opportunities, and strategic directions to guide future anti-amoebic drug development.