Page 953 - Basic _ Clinical Pharmacology ( PDFDrive )

CHAPTER 53 Clinical Pharmacology of the Antihelminthic Drugs 939

TABLE 53–1 Drugs for the treatment of helminthic infections. 1

Infecting Organism Drug of Choice Alternative Drugs
Roundworms (nematodes)
Ascaris lumbricoides (roundworm) Albendazole or pyrantel pamoate or mebendazole Ivermectin, piperazine
Trichuris trichiura (whipworm) Mebendazole or albendazole Ivermectin, oxantel pamoate, drug
combinations
Necator americanus (hookworm); Ancylostoma Albendazole or mebendazole or pyrantel pamoate
duodenale (hookworm)
Strongyloides stercoralis (threadworm) Ivermectin Albendazole or thiabendazole
Enterobius vermicularis (pinworm) Mebendazole or pyrantel pamoate Albendazole
Trichinella spiralis (trichinosis) Mebendazole or albendazole; add corticosteroids
for severe infection
Trichostrongylus species Pyrantel pamoate or mebendazole Albendazole
Cutaneous larva migrans (creeping eruption) Albendazole or ivermectin Thiabendazole (topical)
Visceral larva migrans Albendazole Mebendazole
Angiostrongylus cantonensis Albendazole or mebendazole
Wuchereria bancrofti (filariasis); Brugia malayi Diethylcarbamazine Ivermectin
(filariasis); tropical eosinophilia; Loa loa (loiasis)
Onchocerca volvulus (onchocerciasis) Ivermectin
Dracunculus medinensis (guinea worm) Metronidazole Thiabendazole or mebendazole
Capillaria philippinensis (intestinal capillariasis) Albendazole Mebendazole
Flukes (trematodes)
Schistosoma haematobium (bilharziasis) Praziquantel Metrifonate
Schistosoma mansoni Praziquantel Oxamniquine
Schistosoma japonicum Praziquantel
Clonorchis sinensis (liver fluke); Opisthorchis Praziquantel Albendazole
species
Paragonimus westermani (lung fluke) Praziquantel Bithionol
Fasciola hepatica (sheep liver fluke) Bithionol or triclabendazole
Fasciolopsis buski (large intestinal fluke) Praziquantel or niclosamide
Heterophyes heterophyes; Metagonimus yokogawai Praziquantel or niclosamide
(small intestinal flukes)
Tapeworms (cestodes)
Taenia saginata (beef tapeworm) Praziquantel or niclosamide Mebendazole
Diphyllobothrium latum (fish tapeworm) Praziquantel or niclosamide
Taenia solium (pork tapeworm) Praziquantel or niclosamide
Cysticercosis (pork tapeworm larval stage) Albendazole Praziquantel
Hymenolepis nana (dwarf tapeworm) Praziquantel Niclosamide, nitazoxanide
Echinococcus granulosus (hydatid disease); Albendazole
Echinococcus multilocularis
1
Additional information may be obtained from the Parasitic Disease Drug Service, Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, 30333.
Telephone: (404) 639-3670. Some of the drugs listed are not generally available in the USA.
Clinical Uses is a single dose of 400 mg orally (repeated daily for 2–3 days
for heavy infections and in 2 weeks for pinworm infections).
Albendazole is administered on an empty stomach when used These treatments typically achieve good cure rates and marked
against intraluminal parasites but with a fatty meal when used reduction in egg counts in those not cured. For hookworm
against tissue parasites.
infections and trichuriasis, albendazole at 400 mg orally once
1. Ascariasis, trichuriasis, and hookworm and pinworm daily for 3 days is now recommended, with albendazole showing
infections—For adults and children older than 2 years with improved efficacy over mebendazole. For trichuriasis, combina-
ascariasis and pinworm infections, the treatment for ascariasis tion of either mebendazole or albendazole with ivermectin and