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The Challenge of Parasite Control
Published in Eric S. Loker, Bruce V. Hofkin, Parasitology, 2023
Eric S. Loker, Bruce V. Hofkin
When an anti-parasitic drug is used for treatment, the goal may be the elimination of the parasite within the host or at least the prevention of serious complications associated with chronic infections. Albendazole, for instance, is a mainstay for the treatment of geohelminth (anematode transmitted through contaminated soil) infection (Figure 9.18). Its principal mode of action involves its ability to inhibit the polymerization of tubulin into microtubules. Side effects associated with albendazole include dizziness, headache, vomiting and temporary hair loss. More rarely, it can cause seizures, as well as kidney and liver disorders.
Infection-Associated Ocular Cranial Nerve Palsies
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Hardeep Singh Malhotra, Imran Rizvi, Neeraj Kumar, Kiran Preet Malhotra, Gaurav Kumar, Manoj K. Goyal, Manish Modi, Ravindra Kumar Garg, Vivek Lal
Albendazole can be used for EOM cysticercosis provided the following prerequisites are fulfilled. First, an ocular B-scan should be done to rule out the presence of cysticerci in the vitreoretinal space and those closely abutting the optic nerve or optic canal. Prior surgical excision is warranted by a minimum of 6 weeks, if a decision on the use of albendazole has been taken. Second, multiple cysticerci suggest a potential case of dissemination; thus, caution needs to be exercised to prevent a cardiac nodal block or seizures by getting the necessary investigations (ECG, ECHO, MRI of the brain with SPGR-GAD) done (38). More often than not, brain imaging is done as a part of initial evaluation itself, but the cardiac assessment is conveniently missed. Excellent results have been seen due to increased drug bioavailability owing to vascularity of EOM. Because of possibility of inflammatory reaction of the dying larva, steroids should be initiated a few days before and administered simultaneously along with anti-helminthic therapy. Corticosteroids also help by preventing muscle fibrosis.
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
Albendazole and mebendazole (benzimidazole derivatives) are the drugs of choice for treatment for most nematode infections. Both are pregnancy category C based on animal data suggesting teratogenicity without controlled data in humans. Mebendazole has been used extensively in the second and third trimesters in Sri Lanka, Nepal, and Madagascar, where it is routinely used for deworming in antenatal clinics without evidence of increased adverse outcomes (48). Both albendazole and mebendazole have been used in a number of second- and third-trimester clinical trials to study the benefit of deworming in pregnancy with more than 400 women having been exposed with no increase in adverse events reported (44). There was a case series from Sri Lanka reporting increased congenital anomalies with first-trimester mebendazole use so that is not recommended unless the maternal condition is severe enough to require immediate treatment without regard for fetal risks (49). Mebendazole has very limited excretion in breastmilk so is compatible with breastfeeding. There are inadequate data on albendazole to recommend use during breastfeeding.
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
Albendazole is a benzimidazole drug with a broad-spectrum activity against helminth infections, including many nematodes and cestodes. Its mode of action is not entirely clear, although the drug probably causes metabolic disruption in the parasite through inhibition of the beta-tubulin polymerase [19]. It has been extensively used in mass administration campaigns for the control of the other STH (i.e. hookworm, Ascaris lumbricoides and Trichuris trichiura) in endemic areas [20]. In that context, albendazole is used as a single dose of 400 mg, which proved extremely well tolerated. Few gastrointestinal adverse events have been reported over time with the use of this drug [19]. For the treatment of S. stercoralis infection, a single dose demonstrated exceedingly low efficacy (around 69% cure) [19], so different researchers tested repeated doses of 400 mg twice a day for three to 7 days (Table 1). A subsequent systematic review with meta-analysis showed that the efficacy of albendazole, given either for three or 7 days, was significantly lower than that of ivermectin for the parasitological cure of strongyloidiasis (RR 1.79, 95%CI 1.55 to 2.08), while there was no significant difference in the frequency of adverse events caused by the two drugs [21]. For this reason, albendazole is now considered a second-line treatment for S. stercoralis infection, limited to cases of unavailability or contraindications to ivermectin.
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
Hookworm infection is a known cause of anemia in women, and anemia during pregnancy is further associated with preterm deliveries, low birth weight infants and other adverse pregnancy outcomes [56]. Over 60% of stillbirths are secondary to maternal anemia, and severe anemia in particular, increases the odds of stillbirth by four-fold (OR 4.3, 95% CI 2.8, 41.8) [57,58]. Ancylostoma duodenale and Necator Americanus are the two hookworms that typically infect humans and cause anemia, along with Ascaris lumbricoides (roundworm), and Trichuris trichiura (whipworm) [11]. Nearly 250 million girls and adult women of child-bearing age live in areas that are endemic for these soil-transmitted helminths [11]. Therefore, deworming during pregnancy is an effective tool to reduce anemia, thereby preventing adverse birth outcomes. The benzimidazoles (albendazole and mebendazole) are the two main deworming medications used for preventive chemotherapy regimens [11]. A recent systematic review and meta-analysis found effective cure rates of albendazole and mebendazole against hookworm and roundworm, albeit low efficacy against whipworm [59]. The WHO recommends preventive chemotherapy using a single dose of albendazole or mebendazole for pregnant women, after the first trimester, in areas where the baseline prevalence of hookworm and/or whipworm is 20% or more in pregnant women and where the prevalence of anemia is 40% or higher in pregnant women [11].
Diagnostic and management strategies of ocular cysticercosis: current perspectives
Published in Expert Review of Ophthalmology, 2020
For medication, an effective antiparasitic drug, albendazole can kill the larva. It is might be used as a single agent medication or accompanied with praziquantel [31–34]. The treatment with oral albendazole can give favorable outcome [31]. The recommended oral dosage is 15 mg/kg/day for 1 month [32]. There is no serious side effect of albendazole [32]. If surgical procedure is planned, albendazole should be given prior to surgery aiming at parasiticidal effect. Continuous medication is necessary in postoperative phase [33]. Also, the use of combined antiparasitic drug and antileptic drug for controlling of seizure in patients with occurrence of neurocysticercosis is proven safe [34]. Although classical albendazole is effective in treatment of cysticercosis, there some limitations due to low solubility and poor bioavailability of classical antiparasitic drug [35,36]. In addition, classical cysticidal therapy might increase the risk of unwanted complication due to the induction of host inflammatory reactions [35]. Therefore, coadministration of corticosteroids is recommended. Prednisolone might be useful for control of inflammatory reaction [31]. There is still no standard guideline on the duration of steroid administration for controlling of inflammation reaction. Steroid is usually administered until there is no sign of inflammation. The control of inflammation by prolonged use of steroid is still an issue for consensus.