Role of Chemotherapeutic Agents in the Management of Cystic Echinococcosis

Hydatid disease is caused by infection with the metacestode stage of Echinococcus tapeworms of the family Taeniidae. The primary carriers are dogs and wolves, and humans are accidental hosts that do not contribute to the normal life cycle of this organism. The liver is the most commonly involved organ in the body by cystic echinococcosis (CE) secondary to infection with Echinococcus granulosus. Management options for CE should depend on the World Health Organization (WHO) diagnostic classification. Small (<5 cm) WHO stage CE1 and CE3a cysts may be primarily treated with benzimidazoles; the first-choice drug is albendazole. In some situations the combination of albendazole and praziquantel may be preferred. Chemotherapy with a benzimidazole or albendazole plus praziquantel is also used as adjunctive treatment to surgery and percutaneous treatment. Drug treatments have been the indispensable therapeutic modalities for cystic echinococcosis.Key words: Cystic echinococcosis, Drug treatment, Albendazole, Mebendazole, PraziquantelHydatid disease is caused by infection with the metacestode stage of Echinococcus tapeworms of the family Taeniidae. Four species of Echinococcus cause infection in humans: Echinococcus granulosus and Echinococcus alveolaris are the most common, causing cystic echinococcosis (CE) and alveolar echinococcosis, respectively. The primary carriers are dogs and wolves, and intermediate hosts are sheep, cattle, and deer, Humans are accidental hosts that do not contribute to the normal life cycle of this microorganism. Humans are infected by ingesting ova from soil or water contaminated by the feces of dogs. Hydatid cysts are common in societies where agriculture and raising animals are common, and hydatid disease continues to be a serious public health problem in many countries, including Turkey.^1–6 The most common site is the liver, followed in frequency by lung, kidney, and spleen.^7,8 The other, less common sites, such as the heart, pancreas, bone, brain, and muscles, are very rarely affected.^8–11 The first step in the prevention of hydatid disease is basic hygiene and the second step involves the approach to treatment. No consensus exists regarding the optimal treatment, although medical treatment is effective against larval E granulosus. In this study, we aim to discuss the effectiveness of medical treatment in the management of hydatid disease