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Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Several anthelmintics are available to treated infested women, although it is usually not necessary to treat helminth infections during pregnancy. Both mebendazole (Vermox) and thiabendazole (Mintezol) are effective for a variety of helminths, including pinworms (enterobiasis), whipworm (trichuriasis), roundworm (ascariasis), and hookworm (uncinariasis). According to their manufacturer, none of these drugs was teratogenic in laboratory animals, although there are no adequate human reproduction studies.
Candida and parasitic infection: Helminths, trichomoniasis, lice, scabies, and malaria
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
A description of the classification system for helminths is followed by review of the more commonly identified helminths. The chapter is completed by a description of the commonly used anthelmintic agents and their status for use in pregnancy and lactation. Treatment recommendations for all of the helminths detailed in this chapter are based on (i) the current treatment guidelines in the CDC parasites A to Z Web site (www.cdc.gov/parasites/az/index.html) section for each organism (obtained by selecting the organism from the index and then selecting “Resources for Health Care Professions”) or (ii) The Medical Letter article entitled “Drugs for Parasitic Infections” available at The Medical Letter Web site (www.medicalletter.org). Additional information regarding laboratory diagnosis of helminthic infections can be obtained at the DPDx Web site (www.dpd.cdc.gov/dpdx/HTML/DiagnosticProcedures.htm), which is a service of the CDC Division of Parasitic Diseases and Malaria. Links to the applicable sections of the Medical Letter “Drugs for Parasitic Infections” may also be accessed via the treatment tab for each organism on the DPDx Web site.
Control of Human Intestinal Nematode Infections
Published in Max J. Miller, E. J. Love, Parasitic Diseases: Treatment and Control, 2020
Anthelmintics can be used either for the treatment of individual patients or for community treatments (mass application). In this case the goal is the reduction of the worm load to low levels of intensity and not to eradicate all parasites in the treated cases. In the past, anthelmintics were mostly used to deworm single, symptomatic patients. Such treatment, when symptoms and helminths are present, is called “classical.” Since efficient and well-tolerated broad-spectrum drugs have become available, the indications for anthelmintics can be extended to include large populations. When symptoms are absent but helminths are present, a treatment of the carrier may be desirable.
Ivermectin: a mini-review
Published in Clinical Toxicology, 2022
Ivermectin is generally well tolerated after therapeutic oral exposure when used for anthelminthic purposes. Commonly adverse effects associated with therapeutic anthelminthic ivermectin ingestion include headache, nausea, pain, edema, skin rashes, and dizziness [20]. Pain, swelling, and cutaneous reactions are often reported in patients treated with single-dose therapy for treatment of onchocerciasis, but these side effects may be more closely related to the primary disease process than the treatment provided. In a pharmacokinetic study, healthy adult volunteers tolerated up to 2000 mg/kg of ivermectin without serious toxicity [7]. In this study, transient and mild adverse events (including headache, nausea, dizziness, and rash) occurred at similar frequencies in subjects who received placebo or ivermectin. The incidence of adverse events was not dose-dependent. In school-aged pediatric patients, ivermectin has been tolerated at doses up to 600 mcg/kg [21]. In this population, most adverse events, including headache, abdominal pain, photophobia, and pruritus, were mild and resolved within 48 h of drug administration.
Ocular Toxocariasis: Beyond Typical Patterns through the New Imaging Technologies
Published in Ocular Immunology and Inflammation, 2021
I Hernanz, A Moll-Udina, Belles V. Llorenç, Civera A. Adan
Treatment with systemic steroids in active OT has been classically suggested.1,8,10,31,32 Etiologic approach with systemic antihelminthic drugs (i.e.: Albendazole 400 mg given twice a day for 7–14 days) is the recommended standard treatment for systemic toxocariasis33,34 in combination with steroids.33,35 Vitrectomy is restricted to cases of retinal complications.36,37 So far, no controlled trials have been performed for OT and there are no data regarding intraocular penetration of systemic antihelminthic drugs.1 On the other hand, treatment with albendazole in inactive cases of OT has not demonstrated to aggravate ocular inflammation as postulated in some reports on the basis that larva death could lead to a boost of intraocular inflammation.1,10 For this reason, the role of antihelmintic agents remains unclear, and treatment should be monitored individually as shown in our case series.
Infection-related stillbirth: an update on current knowledge and strategies for prevention
Published in Expert Review of Anti-infective Therapy, 2021
Samia Aleem, Zulfiqar A. Bhutta
In a cross-sectional study done in Sri Lanka, mebendazole treatment during the second trimester of pregnancy was significantly associated with a lower proportion of stillbirths (OR 0.55, 95% CI: 0.4, 0.77) [60]. In contrast, a recent randomized controlled trial in Nigeria did not find any statistically significant differences in the rates of low birth weight (p = 0.56) or perinatal death (p = 0.62) [61]. In this trial, 560 healthy pregnant women were randomized to receiving either a single dose of mebendazole or placebo [61]. Additionally, all women received standard iron supplementation and malaria prophylaxis [61]. In another randomized controlled trial from Uganda investigating albendazole and praziquantel, neither drug showed an effect on the rates of stillbirth [62]. A Cochrane review including four trials of 4265 women did not find an association between a single dose of antihelminthic in the second trimester of pregnancy with maternal anemia during the third trimester (RR 0.94, 95% CI: 0.81, 1.10) [63]. There was also no impact found on the risk of low birthweight, preterm delivery, or perinatal mortality [63].