Benznidazole and Chagas disease: can an old drug be the answer to an old problem?
BACKGROUND
Chagas disease is a significant public health problem in the Americas, despite efforts to decrease the number of new cases since 1990. Etiologic treatment of the disease's chronic phase is still controversial.


OBJECTIVE
We reviewed the strongest studies to evaluate the drugs used in the acute and chronic disease phases, with emphasis on benznidazole.


METHODS
A Medline search using the keywords 'Chagas disease' and 'treatment,' with no date limitations, was performed.


RESULTS
Study methods in completed trials varied greatly, with none being a randomized, double-blind, placebo-controlled study. The only trial using these methods is still ongoing. The treatment in acute phase is the major indication, but during chronic phase doubts still remain.


CONCLUSIONS
Only patients in the acute phase of Chagas disease (whatever their age; including children and adolescents) who are treated have good outcomes, although the criteria defining 'cure' remain controversial.
Mady
Charles
C
University of São Paulo Medical School, Heart Institute (InCor), Av. Dr Eneas C Aguiar, 44, 05403-900 São Paulo, SP, Brazil.
Ianni
Barbara Maria
BM
de Souza
José Leão
JL
D000293:Adolescent; D000328:Adult; D014355:Chagas Disease / Q000188:drug therapy*; D002648:Child; D006801:Humans; D008875:Middle Aged; D009547:Nifurtimox / Q000627:therapeutic use; D009593:Nitroimidazoles / Q000627:therapeutic use*; D014344:Trypanocidal Agents / Q000627:therapeutic use*
D009593:Nitroimidazoles; D014344:Trypanocidal Agents; D009547:Nifurtimox; C009999:benzonidazole