Drugs
:: Drugs 1: Efficacy
Albendzole: a broad spectrum anthelminthic for treatment of individuals and populations.
Authors: Horton, John
Journal: Current Opin Infect Dis 15:599-608 ©2002 Lippincott Williams and Wilkins
Year: 2002
Abstract: Not available.
A randomized controlled trial comparing mebendazole and albendazole against Ascaris, Trichuris and hookworm infections.
Authors: Albonico M et al.
Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene, 88:585-89
Year: 1994
Abstract: The efficacies and side effects of single dose treatments with 500 mg mebendazole (Janssen Pharmaceutica) and 400 mg albendazole (SmithKline Beecham) against intestinal nematodes were compared in a single-blind, randomized controlled trial among 2294 children aged 6 to 12 Year: s on Pemba Island, Zanzibar, among whom infections with Ascaris, hookworms and Trichuris were highly prevalent. Both drugs were highly effective against Ascaris, with cure rates of over 97%. The cure rates for Trichuris were low, but mebendazole was significantly better than albendazole and produced a greater reduction in the geometric mean egg count. Mebendazole was inferior to albendazole in curing hookworm infections and in reducing the geometric mean egg count. There was no difference in the frequency of side effects reported by heavily infected children treated with either drug. In a trial on 402 children, 500 mg mebendazole (Janssen) was compared with a generic version of the drug, 500 mg mebendazole (Pharmamed). No difference was apparent in the efficacies of the 2 treatments against any of the 3 parasites studied.
:: Drugs 2: Resistance
Anthelmintic resistance in human helminths: a review.
Authors: Geerts S and Gryseels B
Journal: Tropical Medicine and International Health, 6(11):915-21
Year: 2001
Abstract: We briefly review reports on drug resistance in human helminths and compare the factors which contribute to the development of anthelmintic resistance in livestock and man, i.e. high treatment frequency, single-drug regimens, targeting and timing of mass treatments and underdosing. Conclusions are drawn from the mistakes in the treatment and control of livestock helminths. The advantages and inconveniences of current methods for the detection of drug resistance in helminths of livestock are discussed and some suggestions are put forward to standardize the tests for the detection of resistance in human helminths. Finally, based on veterinary experience, some recommendations are made to reduce the risks of development of drug resistance in human helminths. The dramatic and rapid spread of resistance to all major classes of veterinary anthelmintics should be a warning against too strong a reliance on drugs in helminth control programmes.
Drug Resistance in Human Helminths: Current Situation and Lessons from Livestock.
Authors: Geerts S and Gryseels B
Journal: Clinical Microbiology Reviews, 13(2):207-222
Year: 2000
Abstract: In this review the available reports on drug resistance in human helminths, particularly hookworms and schistosomes, are critically analyzed. The experiences with helminths of livestock are then reviewed, in particular the factors contributing to the development of anthelmintic resistance, the mechanisms and genetics of resistance to various anthelmintic classes, and the methods available for detection. These experiences appear to be worryingly similar and relevant to the potential development of drug resistance in human helminths. Recommendations to reduce its risks are suggested.
Praziquantel: is there real resistance and are there alternatives?
Authors: Cioli D
Journal: Current opinion in Infectious Diseases, 13:000-000,1-5
Year: 2000
Abstract: The low cure rates obtained with praziquantel in a Senegalese focus of schistosomiasis can best be interpreted on the basis of epidemiological factors, and are unlikely to be connected with any drug resistance in the parasite. Schistosome isolates obtained in Egypt from uncured patients present evidence of lower susceptibility to the drug, albeit to a rather limited extent. Similarly, laboratory schistosomes subjected to repeated passages under drug pressure are partly insensitive to the drug. Oxamniquine is at present the only available alternative to praziquantel. Research and development of new antischistosomal drugs is urgently needed.
:: Drugs 3: Praziquantel and pregnancy
Use of praziquantel in pregnant and lactating women.
Authors: Olds GR et al.
Journal: Essential Medicines: WHO Drug Information Vol 17, No. 1 29-31
Year: 2003
Abstract: -
:: Drugs 4: Albendazole and Praziquantel administration
Double-Blind Placebo-Controlled Study of Concurrent Administration of Albendazole and Praziquantel in Schoolchildren with Schistosomiasis and Geohelminth.
Authors: Olds GR et al.
Journal: The Journal of Infectious Diseases, 179:996-1003
Year: 1999
Abstract: A double-blind placebo-controlled study of the concurrent administration of albendazole and praziquantel was conducted in>1500 children with high prevalences of geohelminths and schistosomiasis. The study sites were in China and the Philippines, including 2 strains of Schistosoma japonicum, and 2 different regions of Kenya, 1 each with endemic Schistosoma mansoni or Schistosoma haematobium. Neither medication affected the cure rate of the other. There was no difference between the side effect rate from albendazole or the double placebo. Praziquantel-treated children had more nausea, abdominal pain, and headache but these side effects were statistically more common in children with schistosomiasis, suggesting a strong influence of dying parasites. The subjects were followed for 6 months for changes in infection status, growth parameters, hemoglobin, and schistosomiasis morbidity. In all 4 sites, a significant 6-month increase in serum hemoglobin was observed in children who received praziquantel, strongly supporting population-based mass treatment.