A placebo controlled study of albendazole in the treatment of pulmonary echinococcosis

Abstract

Infection with Echinococcus granulosus is endemic in Middle Eastern countries. Some patients are noted to undergo spontaneous resolution, but many require surgical removal with its associated risks. Although, there are studies showing favourable responses to medical treatment, there is no controlled study on the effect of albendazole. In this study, 20 patients with 179 E. granulosus cysts affecting the lungs were entered into a triple blind parallel randomized clinical trial comparing the effects of albendazole versus placebo. Fifteen patients (150 cysts) completed 6 months of treatment; four patients (26 cysts) were in the placebo group and 11 patients (124 cysts) in the treatment group receiving 800 mg albendazole daily in three cycles of 6 weeks with 2 weeks between cycles. Ten of 11 patients (91%) in the treatment group showed either cure (five patients) or improvement (five patients); in the placebo group, only one of four (25%) showed spontaneous improvement but no cure. In the treatment group, 88 of 124 cysts (71%) showed improvement compared to four of 26 (15.4%) in the placebo group (p=0.000). Complication from therapy was insignificant; one case had recurrent disease, which responded to further therapy. It is suggested that patients suffering from uncomplicated hydatid disease should be given a trial of albendazole before surgery is considered.

Echinococcus granulosus infection: clinical presentation, medical treatment and outcome

“…The time on drug was further addressed in two recent prospective placebo-controlled studies in Iran. Keshmiri et al [16,42] evaluated the effect of albendazole on hydatid liver and lung cysts. Treatment was given intermittently for a total of 6 months.…”

Pulmonary echinococcosis

“…However, the optimal duration of chemotherapy before and after surgical procedures is not known. Therapy generally should begin o4 days prior to surgery and be continued for 1-3 months [46,49,60].…”

33-jährige Libanesin mit rezidivierenden Hämoptysen und zystischer Raumforderung in der Lunge

“…Pulmonale Zysten sprechen im Vergleich zu abdominalen Zysten signifikant rascher auf eine Behandlung mit Benzimidazolen (Mebendazol oder Albendazol) an [17] und zeigten in einer kontrollierten Studie im Vergleich zu Placebo bereits 1-2 Monate nach Beginn einer Albendazoltherapie eine signifikante Verkleinerungs-bzw. Rückbildungsrate [11].…”