A Two-Phase Approach to the Use of Tafenoquine Was Associated with Cure of Babesiosis in Two Immunocompromised Patients with Relapsing Babesiosis

Q: What does this research mean for the field?

A two-phase treatment regimen consisting of an initial atovaquone-containing drug followed by a prolonged course of tafenoquine successfully cures relapsing babesiosis in immunocompromised patients. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Nonso Osakwe; Gary P. Wormser

doi:10.3390/pathogens15090960

September 9, 2026PathogensOpen Access

A Two-Phase Approach to the Use of Tafenoquine Was Associated with Cure of Babesiosis in Two Immunocompromised Patients with Relapsing Babesiosis

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Key Points

To describe the therapeutic efficacy and tolerability of an extended two-phase tafenoquine and atovaquone regimen for relapsing babesiosis in immunocompromised patients.
Evaluated two immunocompromised patients (N=2) suffering from relapsing babesiosis.
Administered long-term tafenoquine courses of 171 and 212 days, supplemented by an atovaquone-containing drug regimen during the initial 10 days.
Continued tafenoquine treatment until negative polymerase chain reaction testing exceeded the 120-day erythrocyte lifespan before stopping therapy.
Both immunocompromised patients achieved complete cure of relapsing Babesia microti infection without disease recurrence.
Negative polymerase chain reaction results were maintained past the 120-day red blood cell lifespan, and the prolonged treatment regimens were well tolerated.

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Implication

Case series reports successful cure of relapsing babesiosis using extended tafenoquine with atovaquone in immunocompromised patients, highlighting a viable strategy to clear persistent infection.

Abstract

Two immunocompromised patients with relapsing babesiosis were cured using a well-tolerated course of tafenoquine (171 and 212 days, respectively), with negative polymerase chain reactivity intentionally exceeding the 120-day lifespan of erythrocytes before discontinuing the tafenoquine. During the first 10 days of tafenoquine both patients also received an atovaquone-containing drug regimen. This was prescribed based on the demonstrated benefit of atovaquone on the efficacy of tafenoquine for completely eradicating B. microti in an animal study.

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Cite This Study

Osakwe et al. (2026) studied this question.

synapsesocial.com/papers/6aa27c0f58559d80afc75a73 https://doi.org/10.3390/pathogens15090960

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A Two-Phase Approach to the Use of Tafenoquine Was Associated with Cure of Babesiosis in Two Immunocompromised Patients with Relapsing Babesiosis

Key Points

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

A Two-Phase Approach to the Use of Tafenoquine Was Associated with Cure of Babesiosis in Two Immunocompromised Patients with Relapsing Babesiosis

Key Points

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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