General: In otherwise healthy individuals who are not pregnant, no treatment is necessary. Combination therapy of pyrimethamine, sulfadiazine, and folate supplements is the standard method of treatment for toxoplasmosis patients who are immunocompromised or pregnant. Toxoplasmosis patients who have cats should take their pets to their veterinarians to determine whether they carry the parasite.
Pyrimethamine (Daraprim®): Pyrimethamine (Daraprim®) is an antiparasitic medication that is effective against toxoplasmosis. This medication is a folic acid antagonist, which means it may prevent the body from absorbing vitamin B-9 (folic acid), especially when high doses are taken over a long period of time. Therefore, folic acid supplements are also recommended in patients who are taking pyrimethamine. Other potential side effects of pyrimethamine include bone marrow suppression and liver toxicity.
Sulfadiazine (Microsulfon®): Sulfadiazine (Microsulfon®) is an antibiotic that is commonly used in combination with pyrimethamine to treat toxoplasmosis. Possible side effects include nausea, vomiting, and diarrhea.
HIV patients who have toxoplasmosis typically receive pyrimethamine and sulfadiazine, along with folic acid supplements. An alternative treatment is pyrimethamine in addition to the antibiotic clindamycin (Cleocin®). However, clindamycin may cause severe diarrhea. Side effects of most drugs may be more severe in people with HIV. Most patients will need to take these medications for life. In some cases, toxoplasmosis treatment may be discontinued if the patient's CD4 count remains high for at least three to six months.
If a pregnant mother's child is infected with toxoplasmosis, patients may be treated with pyrimethamine and sulfadiazine. However, these are only used in extreme circumstances because they can cause serious side effects in both the mother and baby. While the drugs may lessen the severity of the infection, they cannot repair any damage that has already been done.
Infected pregnant women who have healthy babies may be treated with the antibiotic spiramycin. Use of this drug may reduce the chance that the baby will become infected. Unlike sulfadiazine, spiramycin is not likely to cause serious side effects in the mother or child. While this spiramycin is commonly used to treat toxoplasmosis in Europe, it is still considered an experimental drug in the United States. Healthcare providers may obtain the drug from the U.S. Food and Drug Administration (FDA).
Unclear or conflicting scientific evidence
Early study shows that taking oregano by mouth may help treat parasites. Further research is needed to confirm these results.
Research suggests that oregano is well tolerated in recommended doses. Avoid if allergic or hypersensitive to oregano. Use cautiously if allergic or hypersensitive to other herbs from the Lamiaceae family including hyssop, basil marjoram, mint, sage, and lavender. Use cautiously with diabetes and bleeding disorders.Pregnant or breastfeeding women should not consume oregano at doses above those normally found in food due to insufficient scientific evidence of safety.
Zinc: Preliminary studies have evaluated zinc as a possible treatment for several parasitic infections, including cutaneous leishmaniasis, S. mansoni,and Schistosoma. However, further research is needed to determine whether zinc is an effective treatment for parasitic infections.
The effects of zinc on the rate of parasitic re-infestation have been examined in children. No significant effect of zinc treatment was found. Due to conflicting results in this area, more research is needed before zinc can be recommended for the treatment of parasites.
Zinc is regarded as a relatively safe and generally well-tolerated therapy when taken at recommended doses and few studies report side effects.
Wear gloves when gardening or handling soil. Wash hands thoroughly with soap and water after coming into contact with soil.
Do not eat raw or undercooked meat, especially pork, venison, or lamb.
Wash kitchen utensils thoroughly with soap and water.
Thoroughly wash all fruits and vegetables.
Avoid unpasteurized goat's milk.
Avoid feeding cats raw meat. Indoor cats are less likely to develop toxoplasmosis.
If possible, immunocompromised or pregnant women should not clean litter boxes. Wear gloves when cleaning a cat's litter box. Wash hands thoroughly with soap and water after handling anything that may have come into contact with cat feces.