Biguanides (polyhexidine biguanides, PHMB 0.02%-0.06%, and chlorhexidine 0.02%-0.2%) and diamidines
(propamidine Isethionate 0.1%, Brolene, May and Baker, UK and hexamidine 0.1%, Desmomedine, Chauvin, France) are the most effective cystocidal agents.
Thus, antimonies, aromatic diamidines
or paromomycin sulphates, are associated to a varying degree with cytotoxic effects and important resistance phenomena (Antoniou et al.
The chemoprophylaxis of sleeping sickness with the diamidines
. Ann Trop Med Parasitol.
The next level of drugs is represented by the diamidines, namely propamidine and dibromopropamidine.
These products (eg, diamidine anti-infectives and P medicine chloramphenicol) are marketed with guidelines for their use, and for chloramphenicol these differ slightly from those for the PoM products.
The ideal agent currently available are preparations containing diamidines
, notably dibromopropamidine; Golden Eye Ointment and Brolene Eye Ointment are both available in small 5g tubes as P Medicines.