Chagas disease is a neglected parasitosis caused by the protozoan parasite Trypanosoma cruzi. This infection is present in most Latin American countries, although, due to migratory movements, it is a growing cause for concern in non-endemic countries. The only two drugs currently available for its treatment—benznidazole and nifurtimox—were marketed 50 years ago. While they are very effective for acute and recent infection, and for the prevention of maternofoetal transmission, their efficacy declines in people who have chronic infection, especially those older than 18 years of age. In the presence of visceral involvement, parasiticidal treatment is of little or no value. The safety profile of both drugs is far from ideal, with frequent adverse events and high rates of drug discontinuation, mainly in adults. So far, new drugs and new strategies have not been shown to improve the results of the current nitroimidazoles, although the results are promising. In this review, we focus on the aspects that allow clinicians to make the best use of currently available drugs. In addition, we discuss new therapeutic options and ongoing research in the field.

恰加斯病是由原生动物寄生虫克氏锥虫引起的一种被忽视的寄生虫病. 大多数拉丁美洲国家都存在这种感染，但由于迁徙，它在非流行国家越来越引起人们的关注。目前仅有的两种治疗药物——苯硝唑和硝呋莫司——是在 50 年前上市的。虽然它们对急性和近期感染以及预防母胎传播非常有效，但它们对慢性感染的人，尤其是 18 岁以上的人的疗效会下降。在存在内脏受累的情况下，杀寄生虫治疗几乎没有价值或没有价值。这两种药物的安全性远非理想，不良事件频繁，停药率高，主要是在成人中。到目前为止，还没有显示出新药和新策略可以改善目前硝基咪唑的结果，虽然结果很有希望。在这篇综述中，我们重点关注使临床医生能够充分利用现有药物的方面。此外，我们还讨论了该领域的新治疗方案和正在进行的研究。