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Antimicrobial Drug Prophylaxis for Recurrent Ocular Toxoplasmosis.
Taraneh Keshavarz1, João M Furtado2, Justine R Smith1
1College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5042, Australia.
Pathogens (Basel, Switzerland)
|May 4, 2026
Summary
Antimicrobial prophylaxis can reduce recurrent ocular toxoplasmosis (infectious eye disease) relapses. Trimethoprim-sulfamethoxazole is a preferred treatment, though optimal dosing and duration require further study.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pharmacology
Background:
- Ocular toxoplasmosis is a recurring eye infection with escalating vision loss risk.
- Antimicrobial prophylaxis is employed to mitigate recurrence rates.
- Current literature on expert preferences and prophylaxis efficacy/safety is reviewed.
Purpose of the Study:
- To summarize expert clinician preferences for ocular toxoplasmosis prophylaxis.
- To evaluate the effectiveness and safety of antimicrobial prophylaxis for recurrent ocular toxoplasmosis.
- To identify gaps in current research regarding prophylaxis protocols.
Main Methods:
- A comprehensive literature search was performed using PubMed.
- Four professional surveys were analyzed to determine expert preferences.
- Clinical studies on prophylaxis effectiveness and safety were reviewed, focusing on those with at least 50 participants.
Main Results:
- Approximately 75% of surveyed experts utilize antimicrobial prophylaxis for recurrent ocular toxoplasmosis.
- Trimethoprim-sulfamethoxazole emerged as the most frequently preferred prophylactic agent.
- In studies with >=50 participants, prophylaxis reduced recurrence to 9.1% within 5 years, with side effects in up to 7.9%.
Conclusions:
- Antimicrobial prophylaxis is effective in reducing the recurrence rate of ocular toxoplasmosis.
- Further research is needed to establish optimal drug dosing and treatment duration for prophylaxis.
- Evidence-based guidelines are required to support clinical decision-making in managing ocular toxoplasmosis recurrence.
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