Naegleria fowleri Infection (cont.)
What is the treatment for a Naegleria fowleri infection?
Because Naegleria meningoencephalitis is rare, there are no studies comparing one treatment regimen to another.
The treatment of choice is amphotericin B, which is an intravenous drug usually used for fungal infections. In addition to intravenous treatment, amphotericin B can be instilled directly into the brain (intrathecally). Unfortunately, amphotericin alone often fails, which has led clinicians to use additional drugs. It is strongly recommended that an infectious-diseases expert be consulted to guide therapy. The Centers for Disease Control and Prevention has a supply of a newer agent called miltefosine, which has shown promise in a limited number of recent cases. Miltefosine can be acquired by calling the CDC Emergency Operations Center at 770-488-7100.
Other drugs such as rifampin (Rifadin), voriconazole (Vfend), or azithromycin (Zithromax, Zmax) have activity against Naegleria fowleri and may sometimes be used in combination with amphotericin B. However, there are no scientific studies available to determine the clinical efficacy of these medications and no official recommendation for their use.