Date of Award

Spring 2023

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

McHugo, Jeanie

Second Advisor

Solberg, Julie

Third Advisor

Kauffman, Russell


Toxoplasma, Toxoplasmosis gondii, pyrimethamine, pyrimethamine/sulfadiazine, trimethoprim/sulfamethoxazole


This literature review intends to investigate the safety and efficacy of two different drug treatment regimens, pyrimethamine versus trimethoprim-sulfamethoxazole, for active toxoplasmosis infections. Affecting nearly 11% of the United States population and up to 80% of the populations of tropical countries, Toxoplasmosis infection is the second leading cause of death from food borne illness. Current classic management of active infection with pyrimethamine is correlated with numerous undesirable side effects, high cost and need for complex use of adjunctive medications. It is necessary to identify alternative treatment options with fewer side effects, less complex regimens, lower cost, and easier access for patients with active infection. A literature review was performed using electronic search databases including PubMed, CINAHL Complete, Clinical Key, and Embase. Key search terms and MESH terms included toxoplasmosis, toxoplasmosis therapy, toxoplasmosis drugs, toxoplasmosis AND pyrimethamine, toxoplasmosis AND pyrimethamine sulfadiazine, toxoplasmosis AND trimethoprim-sulfamethoxazole. Exclusion criteria consisted of articles not available in English or free of cost, involved use of animals, completed in vitro, involved congenital toxoplasmosis, involved pregnant participants or studied latent toxoplasmosis. Following application of inclusion/exclusion criteria a total of six articles were reviewed. Collectively these studies indicate trimethoprim-sulfamethoxazole can be an effective and safe treatment option for active Toxoplasmosis infection in some patient cases; however, it is not clear if trimethoprimsulfamethoxazole is more effective than the current gold standard treatment of pyrimethamine during the active stage of disease in all patient cases. Overall, further research is recommended.