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Strongyloidiasis
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
Robert M. Genta, Peter D. Walzer
Treatment of S. stercoralis infection is indicated both in symptomatic and asymptomatic infection. Thiabendazole (Mintezol), a broad-spectrum benzimidazole antihelminthic drug, has long been considered the agent of choice (280). Although its precise mode of action is unclear, thiabendazole may inhibit the parasite enzyme fumarate reductase and also suppress egg or larval development (281). Thiabendazole is administered orally as a chewable tablet or liquid suspension in the dose of 50 mg/kg per day (maximum 3.0 g) in two divided doses for 2 days in the normal host. The drug has an overall success rate of about 70-80%, but this varies among different studies (282). Patients who fail initial treatment with thiabendazole often respond to another course of therapy.
An Overview of Helminthiasis
Published in Venkatesan Jayaprakash, Daniele Castagnolo, Yusuf Özkay, Medicinal Chemistry of Neglected and Tropical Diseases, 2019
Leyla Yurttaș, Betül Kaya Çavușoğlu, Derya Osmaniye, Ulviye Acar Çevik
Thiabendazole (3) was the first broad spectrum benzimidazole anthelmintic drug and it was introduced in the market 1961. Thiabendazole inhibits the helminth-specific mitochondrial fumarate reductase. The other effect of thiabendazole is to bind selectively to parasite β-tubulin and prevent microtubule formation. Thiabendazole is an effective oral drug and it is generally used in the treatment of strongyloidiasis, trichinosis, visceral larva migrans and cutaneous larva migrans (Martin et al. 1997, Köhler 2001, Finch et al. 2010).
Anisakis
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
The first-line treatment for intestinal anisakiasis is surgery, as endoscopy is off limits to the small intestine. Surgical removal of intestinal granuloma serves to confirm diagnosis and to provide a cure. Albendazole (400 mg twice daily for 6–21 days) or tiabendazole may also be utilized. Corticosteroids (e.g., 6-methylprednisolone, 1 mg/kg/24 hours for 5 days) offer an alternative to surgical resection for treating acute intestinal anisakiasis. Prednisolone (5 mg/day for 10 days) and olopatadine hydrochloride (10 mg/day for 6 weeks) are also helpful in resolving intestinal anisakiasis symptoms. For patients with allergy, exclusion of fish from the diet helps relieve symptoms [55–59].
Pediatric Ocular Toxocariasis in Costa Rica: 1998-2018 Experience
Published in Ocular Immunology and Inflammation, 2021
Joaquin Martinez, Gabriela Ivankovich-Escoto, Lihteh Wu
Currently, there are no treatment guidelines for the treatment of ocular toxocariasis. Our treatment decisions have evolved over the experience gained in the past two decades. In general, if the patient presented acutely and there was a chance that the Toxocara larva was still alive, thiabendazole was prescribed either alone or in combination with corticosteroids to decrease the inflammatory reaction. The role of anti-helminthic drugs remains unclear.19,20 Combination therapy of anti-helminthic and corticosteroids may be of use in specific cases.21 In a very small comparative trial, albendazole appeared to be more effective than thiabendazole in the treatment of patients with visceral or ocular larva migrans secondary to toxocariasis.20 In a slightly larger trial, mebendazole and diethylcarbamazine had similar therapeutic efficacy but mebendazole had a lower rate of adverse events. Despite these reports, it is unclear if these anti-helminthic drugs kill intraocular Toxocara larvae. A case report looked at the thiabendazole concentration in ocular fluids following oral administration of the drug. According to Maguire and collegues,22 anti-parasitic levels of the medication can be achieved intraocularly after oral ingestion. Our impression is that anti-helminthic drugs could have some use only in very acute cases, because once the granuloma is formed, or even before, the larva is already dead.
Efflux pump inhibitors as a promising adjunct therapy against drug resistant tuberculosis: a new strategy to revisit mycobacterial targets and repurpose old drugs
Published in Expert Review of Anti-infective Therapy, 2020
Liliana Rodrigues, Pedro Cravo, Miguel Viveiros
Thiabendazole is a fungicide and parasiticide mostly used for the treatment of strongyloidiasis, cutaneous larva migrans, visceral larva migrans, and trichinosis. Thiabendazole is a known inhibitor of tubulin polymerization. It selectively binds to nematode ß-tubulin, inhibiting polymerization, thus preventing the formation of microtubules and preventing cell division [127,128]. Thiabendazole has also been shown to inhibit the helminth-specific enzyme, fumarate reductase [129]. Previous studies examined the effect of thiabendazole in M. tuberculosis and demonstrated that this drug prevented FtsZ polymerization, causing septum formation inhibition and, thus, abolishing cell division [130,131]. Our strategy identified a probable succinate dehydrogenase (Rv0248c) and a probable fumarate reductase (Rv1552) as potential targets of thiabendazole in M. tuberculosis. These enzymes are involved in interconversion of fumarate and succinate in aerobic respiration. Experimental studies are now needed in order to determine if these proteins are indeed targets of thiabendazole.
Current pharmacotherapeutic strategies for Strongyloidiasis and the complications in its treatment
Published in Expert Opinion on Pharmacotherapy, 2022
Dora Buonfrate, Paola Rodari, Beatrice Barda, Wendy Page, Lloyd Einsiedel, Matthew R. Watts
Thiabendazole was the first benzimidazole licensed for human use [19]. Like albendazole, it has a broad-spectrum activity against helminth infections, at the recommended dose of 50 mg/kg/day divided every 12 hours (maximum 3 g/day) for 2 days [19,21]. Different doses have been used in randomized controlled trials (RCT) (Table 1). However, while its demonstrated efficacy was similar to that of ivermectin for the treatment of strongyloidiasis, tolerability was significantly lower, with nausea, malaise, and dizziness among the main adverse events [21]. Based on the high frequency of adverse events caused by thiabendazole, and the availability of anthelminthic drugs of comparable efficacy, the product is no longer in the market in many countries [21].