Albendazole in the treatment of strongyloidiasis

Albendazole was used to treat 30 patients with Strongyloides stercoralis infections. There were 21 males and 9 females, 13 to 68 years of age, who were divided into two groups of 11 and 19, respectively. Repeated pre- and post-treatment stool examinations were done by simple direct smear and formalin-ether concentration, and larval quantitations were done by the Stoll and Sasa's technique. Group I patients were given albendazole in dosages of 400 mg/day in divided doses for 3 days. Group II patients were given similar dosages, but were treated again 7 days later on the same schedule. Patients in Group I were followed for 14 days and those in Group II for 30 days. The cure rates were 73% for Group I and 100% for Group II. Side effects were minimal and transient. Albendazole is recommended for the treatment of strongyloidiasis in dosages of 400 mg/day in divided doses for 3 days with treatment repeated one week later.     

Attempts to modify treatment of intestinal capillariasis

Attempts to reduce the standard treatment of intestinal capillariasis of 200 mg mebendazole twice daily for 20 days were not successful. Two of 13 patients given mebendazole at single daily dosages of 500 mg per day for 16 days relapsed 3 to 6 months after treatment. Attempts to reduce the treatment to 14 days were even less satisfactory in that 4 of 8 patients treated experienced relapses 2 to 9 months later. Since intestinal capillariasis can be fatal it is recommended to continue the use of the standard schedule of 400 mg mebendazole daily for 20 days for new cases and 30 days for relapsed cases until a more effective drug is available.     

不同剂量阿苯达唑和甲苯咪唑对土源性线虫感染疗效的随机对照试验

目的观察单倍、三倍剂量阿苯达唑和甲苯咪唑治疗土源性线虫感染的效果。方法采用随机对照试验,对314位调查对象随机分为阿苯达唑(400mg)、甲苯咪唑(500mg)、三倍阿苯达唑(400mg,3d)、三倍甲苯咪唑(500mg,3d)等4组,对各药物组治疗蛔虫、钩虫、鞭虫和绦虫感染的疗效进行观察,计算治愈率和粪样虫卵下降率。结果阿苯达唑治疗钩虫的疗效优于甲苯咪唑,两药单倍剂量对钩虫的治愈率分别为69.1%和31.0%,三倍剂量组治愈率分别为92.0%和54。0%,虫卵下降率单倍剂量组为97.3%和83.6%,三倍剂量组为99.7%和96.4%。控制鞭虫感染,三倍剂量疗效优于单倍剂量。两驱虫药物单倍或三倍剂量对蛔虫感染疗效显著(治愈率在93.0%～96.8%之间,虫卵下降率均大于99.9%)。三倍剂量对绦虫感染的治愈率为100%,而单倍剂量仅为50%。结论治疗钩虫和鞭虫感染,三倍剂量方案可获得较高的治愈率。     

两种药物治疗广州管圆线虫病的效果观察

目的　观察阿苯哒唑和甲苯咪唑治疗广州管圆线虫病的效果。　方法　以大白鼠为动物模型 ,用不同剂量和不同疗程的阿苯哒唑和甲苯咪唑进行治疗 ,然后解剖检虫、计数、观察 ,同时对广州管圆线虫病病人进行治疗。　结果　阿苯哒唑和甲苯咪唑总剂量达 12 0 mg/ kg时可杀死鼠体内的虫体 ;总剂量为 6 0 mg/ kg,疗程达 6 d时 ,也可杀灭虫体。但总剂量也为 6 0 mg/ kg而疗程只有 3d或总剂量 <6 0 mg/ kg时 ,部分虫体仍可存活 ,但虫体的发育受到严重影响 ,无法达到性成熟 ,不能产卵。对部分确诊的广州管圆线虫病病人进行治疗也收到很好的效果。　结论　阿苯哒唑和甲苯咪唑两种药物对广州管圆线虫病有显著的疗效。     

甲苯咪唑新剂型（微丸）治疗小鼠细粒棘球蚴的效果观察

通过体外和动物实验证实甲苯咪唑（Ｍｅｂｅｎｄａｚｏｌｅ ＭＢＺ）微丸的抗细粒棘球蚴的作用。在试管内观测不同浓度甲苯咪唑微丸对原头节的致死作用,将甲苯咪唑微丸制成１００ｍｇ／ｋｇ．５００ｍｇ／ｋｇ和２５ｍｇ／ｋｇ三个不同剂量悬液对感染细粒棘球蚴６个月的小鼠经口灌胃,每日一次,连续给药２０ｄ,停药７ｄ后剖检,以棘球蚴囊重抑制率、塌囊率和组织病理改变为指标,同法将甲苯唑片剂和原粉制成悬液按相同剂量给药,     

4种药物单用或联用治疗大鼠华支睾吸虫感染的实验研究

目的观察三苯双脒(TBD)、青蒿琥酯(AS)、阿苯达唑(ABZ)、甲苯咪唑(MBZ)单用或联用治疗感染华支睾吸虫大鼠的疗效。方法 140只大鼠各感染华支睾吸虫囊蚴100个,于感染后第5周开始分组治疗,均采用灌胃给药。感染大鼠随机分为药物治疗组同批感染对照组(每组5～10只),将TBD、AS、ABZ与MBZ分别按照高、低剂量单剂用药和两两配伍给药,顿服,观察疗效。治疗后10d处死大鼠,解剖,收集胆管和肝组织内的华支睾吸虫,计算平均虫数和减虫率,对相应组间的平均虫数进行单因素方差分析。结果感染华支睾吸虫大鼠用75mg/kg体重TBD、MBZ、ABZ单剂治疗后,平均减虫率分别为98.04%、100%和86.67%,30mg/kg体重AS治疗后减虫率为87.25%;当给药剂量均降低1/3时,上述各药物治疗组的平均减虫率分别降至78.3%、46.02%、31.94%和62.07%。50mg/kg体重TBD分别与50mg/kg体重MBZ、ABZ配伍用组平均减虫率为98.43%和100%,检虫数与75mg/kg体重TBD、MBZ、ABZ单用药组比较,差异有统计学意义(P<0.05)。20mg/kg体重AS分别与50mg/kg体重ABZ、50mg/kg体重MBZ配伍用,平均减虫率为89.22%和97.55%,检虫数与75mg/kg体重ABZ、MBZ,30mg/kg体重AS单用药组比较,差异有统计学意义(P<0.05)。结论联合用药可降低给药剂量,并具有增效作用,50mg/kg体重TBD分别与50mg/kg体重MBZ、ABI配伍用对治疗大鼠华支睾吸虫病疗效较好。     

Treatment of cutaneous larva migrans with albendazole. Preliminary report

Twenty three patients with Cutaneous Larva Migrans syndrome were prospectively treated with 400 mg/day of Albendazole for 3 consecutive days. Clinical response, compliance and tolerance was excellent. Patients were asymptomatic within the first 72 hours of treatment and recurrences did not occurred. Preliminary results with three additional patients suggest that a single oral 400 mg dose may be effective as well.     

联合化疗对人体内肠线虫卵作用的研究

选用阿苯达唑３００ｍｇ伍用复方甲苯达唑３７５ｍｇ１．５ｄ联合疗法分别治疗蛔虫感染者７例、鞭虫感染者７例和钩虫感染者９例。治后３ｄ内粪检蛔虫卵全部转阴，鞭虫卵和钩虫卵亦于治后５ｄ内全部转阴。连续粪便培养发现，治后虫卵发育率较治前明显降低，治后２ｄ对蛔虫、鞭虫和钩虫的杀卵率分别达９８．８％、１００％和１００％。研究结果表明，联合化疗具较强的体内驱虫杀卵作用。     

Treatment of strongyloidiasis with mebendazole and its combination with thiabendazole

Although Strongyloides stercoralis (S. stercoralis) infection rate in Okinawa Prefecture was less than 2% by the traditional method, it has been proven to be 6.2% by the new technique--agar plate method. Thiabendazole has strong activity to eradicate the organism, but it is well known that the rate of severe side effects is extremely high. Therefore, we attempted to evaluate the new treatment for the infection by mebendazole and its combination with thiabendazole. The reason for use of the drug is based on the reports of successful treatment of S. stercoralis infection in humans with the mild and infrequent side effects produced by the drug. Thirty three patients were orally given mebendazole 100 mg twice daily for 28 days. Twenty six patients were given thiabendazole 500 mg thrice daily for 5 days and after that, mebendazole 100 mg twice daily for 9 days. This combination therapy was repeated twice. The following results were obtained: 1) Out of a total of 59 patients, the cure rate was 83.3% (20/24) in single use of mebendazole and 100.0% (22/22) in the combination therapy. 2) Constipation (9.1%) and headache (9.1%) were of relatively high incidence in the mebendazole group, but they were mild. Nausea (19.2%) and headache (15.4%) were observed in the combination therapy group and the drug was discontinued in 2 patients. 3) The incidence of the elevation of S-GOT, S-GPT was noted in 71.4% (20/28) for the mebendazole group and 52.2% (12/23) for combination therapy group. All 13 patients of the mebendazole group were negative in lymphocyte stimulation test for mebendazole.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of single-dose albendazole and single-dose mebendazole on Necator americanus

One hundred two children (43 males and 59 females) aged 6 to 14 years with positive stool examination by Kato-Katz and/or Harada-Mori culture techniques for N. americanus, were randomly divided into two groups. Group I with 48 children were treated with a single dose albendazole, 400 mg. Group II, 54 children, received a single dose mebendazole, 600 mg. After treatment, repeated stool examination was performed on Day 14, Day 21 and Day 28. The children were considered cured when stool examination was negative on all three occasions by both methods. The cure rate was 64% in Group I and 11% in Group II. The difference was statistically significant (p less than 0.05). The eggs reduction rate was 98% in Group I and 95% in Group II. Mild and transient side effects such as nausea, dizziness and headache were observed in both groups. Albendazole, 400 mg, as a single dose treatment was shown to be superior to mebendazole, 600 mg, single dose for the mass treatment of hookworm infection, especially that of Necator americanus, in an endemic area.     

Blinded, placebo-controlled trial of antiparasitic drugs for trichinosis myositis

There is no consensus on the benefits of treatment with any specific anthelminthic compound on muscle-stage trichinosis. A double-blind, placebo-controlled comparison was done of 3 antiparasitic drugs during an outbreak of trichinosis in Chiangrai Province, northern Thailand. Forty-six adults were randomized to receive 10 days of oral treatment with mebendazole (200 mg twice a day), thiabendazole (25 mg/kg twice a day), fluconazole (400 mg initially, then 200 mg daily), or placebo. All patients received treatment to eradicate adult intestinal worms. Trichinella spiralis infection was proved parasitologically in 19 (41%) of 46 patient and by serodiagnosis in all cases. Significantly more patients improved after treatment with mebendazole (12/12) and thiabendazole (7/7) than after treatment with placebo (6/12; P<.05) or fluconazole (6/12). Muscle tenderness resolved in more patients treated with thiabendazole and mebendazole than in those treated with placebo (P<.05). However, 30% of volunteers could not tolerate the side effects of thiabendazole. In summary, Trichinella myositis responds to thiabendazole and to mebendazole.     

Albendazole plus praziquantel versus albendazole alone as a pre-operative treatment in intra-abdominal hydatidosis caused by Echinococcus granulosus

Summary objective  To compare the effects of a combined medication of albendazole (10 mg/kg/day) plus praziquantel (25 mg/kg/day) to those of albendazole alone at different doses (10 and 20 mg/kg/day).
method  The protoscoleces9 viability was studied in a consecutive series of patients affected by intra-abdominal hydatidosis caused by Echinococcus granulosus . In all cases the drugs were given during the month prior to surgery.
results  A significant increase of patients with nonviable protoscoleces was observed in the group treated with the scolicides combination compared to those treated with albendazole alone, both at a dose of 10 mg/kg/day ( P = 0.004) and at a dose of 20 mg/kg/day ( P = 0.03). Albendazole sulphoxide levels in serum and in cyst fluid were higher in patients given the combined therapy than in those who received only albendazole (10 mg/kg/day: P = 0.016; 20 mg/kg/day: P = 0.034). Levels in the cysts were not significantly different probably due to the sample size; nevertheless a lineal relation between the values obtained in serum and inside the cysts could be discerned in the patients treated with the combined medication.
conclusion  Albendazole plus praziquantel is more effective than monotherapy with albendazole in the preoperative treatment of intra-abdominal hydatidosis.     

Ovicidal effects of albendazole in human ascariasis, ancylostomiasis and trichuriasis

Albendazole, a broad spectrum anthelmintic, was administered as a 400 mg single dose to 20 patients harbouring Ascaris (ten cases), hookworms (four cases each of Ancylostoma duodenale and Necator americanus) and trichuriasis (ten cases). Faeces were obtained before treatment and during the following five days. Coprocultures were made for 90 days for Ascaris and Trichuris eggs, hookworm eggs were cultured by the Harada-Mori technique for at least eight days. Albendazole was ovicidal against all four genera of nematodes.     

Experience in the chemotherapy of severe,inoperable echinococcosis in man

Summary The effect of albendazole and mebendazole was studied in 25 patients with severe, multiple, inoperable echinococcosis. Eleven patients were treated with albendazole 10 mg/kg/day for four courses of 30 days with 15-day drug-free intervals and 14 with mebendazole 50–70 mg/kg/day continuously for between 6 and 24 months. The determination of cyst response was based on the changes in cyst appearance as seen by radiography, ultrasound and computed tomography. Albendazole and mebendazole were found to have favourable effects in patients with severe, inoperable hydatid disease, although the degree of response varied. Treatment with albendazole was successful in seven cases, partially successful in two, and failure was noted in the other two patients. In patients treated with mebendazole, success was established in three, partial success in five and failure in six cases. The differences in response were mainly associated with cyst condition and the drug used. In some cases long-term therapy and retreatment should be recommended.

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Erfahrung mit der Chemotherapie der schweren, inoperablen Echinokokkose des Menschen

Zusammenfassung Die Wirkung von Albendazol und Mebendazol wurde bei 25 Patienten mit schwerer, multipler und inoperabler Echinokokkose untersucht. Elf Patienten wurden mit Albendazol in der Dosierung von 10 mg/kg Körpergewicht/die über 4 Kurse von 30 Tagen mit 15 Tagen zwischen Kursen und 14 Patienten mit Mebendazol 50–70 mg/kg/Körpergewicht/die über 6–24 Monate behandelt. Die Beurteilung der Therapiewirkung wurde aufgrund der Änderungen der röntgenologischen, sonographischen und computertomographischen Befunde durchgeführt. Es wurde festgestellt, daß Albendazol und Mebendazol eine günstige therapeutische Wirkung bei Patienten mit schwerer, inoperabler Echinokokkose haben. Die Therapie mit Albendazol war bei sieben Patienten erfolgreich, erzielte Teilerfolge bei zwei Patienten und war erfolglos bei zwei weiteren Patienten. Mit Mebendazol wurde bei drei Patienten ein Therapieerfolg, bei fünf ein Teilerfolg und in sieben Fällen ein Mißerfolg beobachtet. Die Unterschiede in den therapeutischen Ergebnissen wurden hauptsächlich mit dem Zustand der Zysten, aber auch mit dem benutzten Medikament in Verbindung gebracht. Bei manchen Patienten war eine längere und wiederholte Therapie nötig.

     

Treatment of histoplasmosis and blastomycosis

Prior to the development of ketoconazole, the treatment of systemic histoplasmosis and blastomycosis was limited to AMB. The convenience of oral dosing, combined with avoidance of the significant toxicities associated with AMB, make ketoconazole an attractive alternative for the treatment of selected forms of histoplasmosis and blastomycosis. Although high-dose (800 mg/day) ketoconazole is generally more effective than low-dose (400 mg/day), therapy should be initiated at the lower dose due to significantly more adverse effects at higher doses; the daily dose should be increased in patients with progressive disease. Caution should be exercised when ketoconazole is used to treat patients with GU tract disease and in patients with naturally occurring or pharmacologically induced achlorhydria. Thus, AMB remains the drug of choice for difficult to treat cases of histoplasmosis and blastomycosis; however, recent studies have established ketoconazole as the drug of choice in immunocompetent patients with non-life-threatening, non-meningeal H capsulatum and B dermatitidis disease.     

An obstinate case of intestinal capillariasis

A patient who experienced episodes of intestinal capillariasis caused by Capillaria philippinensis 16 times is presented. The patient was first seen in July 1967 with the parasitosis and was treated with thiabendazole. He experienced a relapse in October 1967. He was readmitted to the hospital again in 1969, twice in 1971, twice in 1972, twice in 1973, once each in 1975, 1976, three times in 1978 and twice in 1979. During this period he was treated with various dosages of thiabendazole, mebendazole and flubendazole. At the final admission he was treated with mebendazole, 600 mg per day for 49 days, 200 mg per day for 30 days and 100 mg daily for 6 months. The patient was cured and had no further relapses in 5 years. The recommended dosage of mebendazole is 200 per day for 20 days for new cases and 30 days for relapses. It is advised to over-treat the infection rather than under-treat because of the problem of relapses. Internal autoinfection occurs and it is believed that the drug acts selectively on the adults and not the larval forms of the parasite.     

The effect of albendazole on the prevention of secondary hydatidosis

BACKGROUND/AIMS: Secondary hydatidosis and recurrence are serious complications in hydatid surgery. Although medical treatment and current surgical techniques are more effective in the prevention of cyst formation resulting from spillage of cystic liquid, secondary hydatidosis is still surgically important. Albendazole, a derivative of benzoimidazole, is the most commonly used drug in the medical treatment of echinococcosis. The effectiveness of pre-operative prolonged or single dose applications is supported by the literature. METHODOLOGY: Twenty-two cases of hepatic hydatidosis are evaluated and treated by surgery. Perioperative albendazole treatment was given in a dose of 12-15 mg/kg/day in 4 divided doses. The treatment began 5-20 days before the surgery and continued 3-7 months in a cyclic monthly form, until latex agglutination tests were negative. In the postoperative period, hematological, ultrasonography and computed tomography scan evaluation was carried out. The follow-up period for 21 patients was 6-31 months (mean: 20.52 months). RESULTS: There was no secondary hydatidosis, recurrence or mortality in this study. Early and late morbidity rates were 4.54% and 13.63% respectively. CONCLUSIONS: Our results support that perioperative albendazole treatment is effective in the prevention of secondary hydatidosis.     

Ketoconazole therapy for systemic fungal infections: inadequacy of standard dosage regimens

We treated 29 patients with ketoconazole for systemic mycoses. Twenty-two had coccidioidomycosis, 5 had histoplasmosis, and 2 had sporotrichosis. Of the 25 patients who received 200 mg/day, 16% improved on that dose. Of 17 patients who did not improve on 200 mg/day, 71% responded after the dose was increased to 400 or 800 mg/day. Treatment periods ranged from 21 days to more than 600 days. Five patients relapsed. In 2, ketoconazole had been reduced in dose or discontinued. In 3, the drug was still being given. Ketoconazole is effective in suppressing disease in various mycoses. However, patients may require high doses for prolonged periods to achieve maximal benefit.     

Efficacy of a triple therapy with rabeprazole, amoxicillin, and faropenem as second-line treatment after failure of initial Helicobacter pylori eradication therapy

BACKGROUND/AIMS: Triple therapy consisting of lansoprazole, amoxicillin, and clarithromycin (LAC regimen) is widely used to eradicate Helicobacter pylori in Japan. However, the need for appropriate treatment after failure of initial therapy to eradicate H. pylori has been increasing. We therefore assessed the efficacy of a combination of rabeprazole, amoxicillin, and faropenem for second-line eradication therapy. METHODOLOGY: The subjects were 116 patients positive for H. pylori infection. Patients initially received lansoprazole 60 mg/day, amoxicillin 1500 mg/day and clarithromycin 400 mg/day in two divided doses for 7 days. Patients in whom eradication treatment failed were given rabeprazole 20 mg/day and amoxicillin 1500 mg/day in two divided doses, and faropenem 600 mg/day in three divided doses (RAF regimen) for 7 consecutive days. H. pylori status was assessed by the 13C-urea breath test combined with rapid urease test or H. pylori culture method 8 weeks after completion of therapy. Susceptibility to clarithromycin was determined by the agar dilution method, and genetic polymorphism of CYP2C19 was analyzed by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: The initial H. pylori eradication rate with the LAC regimen was 76.4% (84/110). Assessment of the CYP2C19 genotypes of the patients in whom eradication therapy failed revealed that homozygous extensive metabolizers accounted for 70.0% (16/23) and heterozygous extensive metabolizers for 30.0% (7/23), with no poor metabolizers. The acquired resistance rate for clarithromycin was 52.0% (12/23). The success rate of re-eradication with the RAF regimen was 91.3% (21/23) with no serious adverse effects. CONCLUSIONS: Triple therapy comprising rabeprazole, amoxicillin, and faropenem is effective for second-line eradication treatment of H. pylori infection, regardless of the genetic polymorphism of CYP2C19 or the presence of resistance to clarithromycin.     

Ketoconazole in vulvovaginal candidosis

The efficacy of ketoconazole, a new oral antimycotic agent, was evaluated in an open trial. Forty-two nonpregnant women were selected on the basis of proven vulvovaginal candidosis and were divided into two groups. One group received 400 mg of ketoconazole per day for three days, and the other group received 200 mg per day for three days. Of the 26 patients who received the 400-mg dosage, 24 were cured; of the 16 patients who received the 200-mg dosage, nine were cured. No adverse effects attributable to the drug were found.