Mebendazole
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Trichinella spiralis is a larval nematode infection in man and animals, resulting from autoinfection from adults in the intestine invading body and encysting in the muscles. Infection in man results from ingestion of meat containing larvae. It is uncommon, but is worldwide in distribution. Because meat inspection is generally effective, T. spiralis is rare and clinical studies of outbreaks are few. Mebendazole has been used to eradicate adult worms from the intestine, and less successfully to treat the migrating larvae. High doses are needed (50 mg/kg for 7 days) for efficacy (Horstmann et al., 1982; Levin, 1983), and lower doses, even when taken for longer periods of time, are less effective (Mittermayer and Spaldonova, 1981). Although no direct comparative clinical studies exist, it would appear that albendazole has more effect on the encysted larvae, with much greater cure rates (Kociecka et al., 1989), and is therefore preferred. Mebendazole has been used as post-exposure prophylaxis with good results in a number of outbreaks in Europe, the most recent being in 2013 (Faber et al., 2015). However, information on the dose and duration used is unclear, and appears to vary widely.
An Overview of Helminthiasis
Venkatesan Jayaprakash, Daniele Castagnolo, Yusuf Özkay in Medicinal Chemistry of Neglected and Tropical Diseases, 2019
Mebendazole (4), a synthetic benzimidazole, is the agent most widely used against enterobiasis, ascariasis, ankylostomiasis, strongyloidiasis, trichocephaliasis, trichostrongyliasis and mixed helminthosis. Mebendazole binds to parasite tubulin thereby inhibiting irreversibly the uptake and utilization of glucose, which causes glucose depletion in the worm. The treatment of massive worm infections with mebendazole is accompanied by abdominal pain and diarrhea. Mebendazole is contraindicated during pregnancy (Vardanyan and Hruby 2006, Kuhlmann and Fleckenstein 2017). Mebendazole can be synthesized by the reaction of 3,4-diaminobenzophenone with N-methoxycarbonyl-S-methylthiourea according to Scheme 3. The building scaffold 3,4-diaminobenzophenone is synthesized by a three-step procedure. Firstly, the nitration of 4-chlorobenzophenone with nitric acid at a temperature lower than 5°C is resulted in the formation of 4-chloro-3-nitrobenzophenone. In the second step, the obtained intermediate is heated to 125°C in a solution of ammonia in methanol to obtain 4-amino-3-nitrobenzophenone. Finally, the reduction of nitro group in this compound with hydrogen using a palladium on carbon catalyst provides 3,4-diaminobenzophenone. N-methoxycarbonyl-S-methylthiourea is synthesized by the reaction of methyl chloroformate with S-methylthiourea (Vardanyan and Hruby 2006). The synthesis of Mebendazole (4), Albendazole (5) and Niridazole (6).
Trichuris
Dongyou Liu in Handbook of Foodborne Diseases, 2018
Anthelminthic medications (drugs that rid the body of parasitic worms), such as albendazole, mebendazole, and ivermectin, are the drugs of choice for trichuriasis treatment. Health-care providers may decide to repeat a stool exam after treatment. Iron supplements may also be prescribed if the infected person suffers from anemia.5 Mebendazole taken by mouth (100 mg twice a day) for 3 days is commonly prescribed when the infection causes symptoms. Albendazole (400 mg orally) or ivermectin (200 mcg/kg/day orally) for 3 days may sometimes be used.
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.
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].
A holistic approach is needed to control the perpetual burden of soil-transmitted helminth infections among indigenous schoolchildren in Malaysia
Published in Pathogens and Global Health, 2020
Nabil A. Nasr, Hesham M. Al-Mekhlafi, Yvonne A. L. Lim, Fatin Nur Elyana, Hany Sady, Wahib M. Atroosh, Salwa Dawaki, Ahmed K. Al-Delaimy, Mona A. Al-Areeqi, Abkar A. Wehaish, Tengku Shahrul Anuar, Rohela Mahmud
The current WHO target for the three main STH infections is to eliminate morbidity in high-risk groups (e.g. school-age children) by reducing the prevalence of moderate-to-heavy infections to below 1% by 2020. [52] The mainstay of current STH prevention and control programmes is population-based, periodic MDA, which has been well documented as being completely safe and cost-effective. In order to implement a proper MDA strategy, the targeted populations are first classified based on the prevalence of infections, and single-dose of either albendazole (400 mg) or mebendazole (500 mg) is recommended biannually if the prevalence of any STH infection among school-age children is higher than 50% or annually if STH prevalence is between 20% and 50%. [53,54] In the current study, the prevalence of A. lumbricoides and T. trichiura infections among the studied schoolchildren was 63.1% and 61.8%, respectively. Thus, biannual single-dose albendazole (400 mg) should be implemented. In addition to the STH species identified in the current study, a previous study reported a prevalence of 15.8% for S. stercoralis among these children [39].
Related Knowledge Centers
- Ascariasis
- Dracunculiasis
- Echinococcosis
- Headache
- Medication
- Parasitic Worm
- Pinworm Infection
- Hookworm Infection
- Giardiasis
- Oral Administration