High oral doses of mebendazole interfere with growth of larval Echinococcus multilocularis lesions

P, Luder; Robotti, Guidi; Meister, F.; Bircher, J

doi:10.1016/s0168-8278(85)80774-1

Cited by 34 publications

(23 citation statements)

References 13 publications

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“…Benzoimidazole carbamates sometimes have a parasitocidal and sometimes a parasitostatic action, as suggested by the relapses frequently observed after suspension of treatment, as if the drugs can sterilize and stop the growth of echinococci but not completely kill them (2,17,20,24).…”

Section: Discussionmentioning

confidence: 99%

“…In the early 1970s, some benzoimidazole carbamates were proved to be effective against Echinococcus granulosus and, since then, many investigators have employed mebendazole and albendazole for the treatment of human hydatid disease (4,8,14,20,21,24,27,28,31). These drugs inhibit tubulin and induce blockage of glucose absorption, glycogen depletion, and degenerative alterations in the endoplasmic reticulum and mitochondria of the germinal layer, increasing lysosomes and producing cellular autolysis (6,13,18,20,32).…”

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confidence: 99%

“…These drugs inhibit tubulin and induce blockage of glucose absorption, glycogen depletion, and degenerative alterations in the endoplasmic reticulum and mitochondria of the germinal layer, increasing lysosomes and producing cellular autolysis (6,13,18,20,32).…”

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confidence: 99%

“…After encouraging experimental results observed both in vitro and in laboratory animals for the treatment of adult and larval stages of cestodes (6,12,15,17), mebendazole, a broad-spectrum anthelmintic drug, was the first benzoimidazole carbamate used in the treatment of human hydatidosis (9,13,16,20,24,28).…”

mentioning

confidence: 99%

“…Levels of this metabolite in serum may be as much as 10 times higher than those produced by equivalent therapeutic doses of mebendazole (7,20,21,27). In addition, experimental data suggest that a concentration of at least 250 p,g of albendazole per liter for 7 to 10 days or 50 ,ug/liter for 30 days in in vitro cultures is required for complete protoscolex devitalization (23).…”

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confidence: 99%

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Therapy of human hydatid disease with mebendazole and albendazole

Teggi

Lastilla

Rosa

1993

Antimicrob Agents Chemother

208

153

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We report our experience in the treatment with benzoimidazole carbamates (mebendazole and albendazole) of 337 patients affected by hydatid cysts with different localizations. The treated cysts showed degenerative modifications in 50.6% of the cases after mebendazole treatment and in about 80%o after albendazole treatment. Relapses after therapy were observed in 30%o of the cases; about 95% of the recurring cysts showed good susceptibility to a further cycle of therapy with benzoimidazole carbamates. Side effects observed with either drug were not severe and always reversible, consisting mainly of abdominal pains and increased levels of transaminases in serum. Among the factors that may influence the therapeutic results are the drug employed, the age of the cysts, the age of the patient, and the localization of the cysts and their morphological characteristics. Moreover, it can be hypothesized that each hydatid cyst has an intrinsic sensitivity to benzoimidazole carbamates.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Therapy of human hydatid disease with mebendazole and albendazole

Teggi

Lastilla

Rosa

1993

Antimicrob Agents Chemother

208

153

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Orthotopic liver transplantation for incurable alveolar echinococcosis of the liver: Report of 17 cases

Bresson‐Hadni¹,

Franza²,

Miguet³

et al. 1991

Hepatology

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Between 1986 and 1989, orthotopic liver transplantations were performed in our unit for 17 patients with incurable alveolar echinococcosis. Ten patients had hilar involvement (group I), and seven patients had posterior localization (five of them had chronic Budd-Chiari syndrome) (group II). The delay between diagnosis and the orthotopic liver transplantation was more than 48 mo in group Ia (six patients), less than 24 mo in group Ib (four patients) and less than 48 mo in group II. Previous operations were more common in group Ia than in group Ib and II. Five patients have died-four in group I and one in group II. The actuarial survival rate at 15 mo was 75%. Early reoperations were frequent (69%), mainly caused by rebleeding. Bacterial and fungal infections occurred only in group Ia (four cases) and group II (three cases). In eight patients (palliative group), residual foci of infected nonhepatic tissue occurred after surgery. The titer of specific antibodies decreased during the first 3 mo in all the patients but one. In patients with radical liver transplantation, the complete disappearance of specific antibodies occurred within 2 yr in four cases. In the remaining five patients, specific antibodies remained detectable, but no evidence of recurrence has been obtained up to now. In the palliative group, a peak of specific IgM occurred at 3 mo; an increase of specific IgG was observed later. The growth of residual parasitic foci was relatively slow, and all these patients remained asymptomatic with a mean follow-up of 19 mo. We conclude that orthotopic liver transplantation is feasible in incurable alveolar echinococcosis and could be proposed without delay to patients with parasitic Budd-Chiari syndrome or complicated secondary biliary cirrhosis. In the other cases, the best time to perform an orthotopic liver transplantation is more difficult to determine. Nevertheless, in the perspective of an orthotopic liver transplantation, the management of these patients has to change, and repetitive laparotomies for palliative surgical procedures have to be replaced by interventional radiology.

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Effect of chemotherapy on the larval mass and the long-term course of alveolar echinococcosis

et al. 1994

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The efficacy of long-term chemotherapy in nonresectable alveolar echinococcosis is debated, particularly because of the difficulty in defining therapeutic success. In this study the effect of chemotherapy on the parasitic mass was evaluated in a series of 37 patients. The patients had larval lesions documented by serial computed tomography studies at least 1.5 yr after chemotherapy (mean = 6.4 yr, range = 1.5 to 10.7 yr). The therapeutic regimen consisted of mebendazole (n = 34) or albendazole (n = 3) as previously described. The maximal areas of the parasitic lesions were assessed morphometrically by means of digital image analysis, utilizing the point-integration method, before and after chemotherapy. Marked regression of larval tissue occurred in 18 patients (group A; 48.6%), stationary lesions were noted in 13 patients (group C; 35.1%) and progression was found in 6 patients (group B; 16.2%). The three groups did not differ significantly with regard to age, plasma drug levels, duration of chemotherapy or initial size and composition of lesions (e.g., cystic cavities, degree of calcification). Despite morphologically successful chemotherapy in moist patients (e.g., 84%; groups A and C), late cholestatic complications after 1.5 to 11 yr of chemotherapy occurred in 10 patients (group A, n = 7; group C, n = 3; 4 of them died) and esophageal variceal bleeding occurred in 3 patients (relieved by sclerotherapy). These late complications were probably mainly due to posttherapy fibrosis of hilar structures. In conclusion, our data support the efficacy of chemotherapy. However, chemotherapy is not curative, and severe late complications were observed in patients with hilar (fibrotic) involvement.

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High oral doses of mebendazole interfere with growth of larval Echinococcus multilocularis lesions

Cited by 34 publications

References 13 publications

Therapy of human hydatid disease with mebendazole and albendazole

Therapy of human hydatid disease with mebendazole and albendazole

Orthotopic liver transplantation for incurable alveolar echinococcosis of the liver: Report of 17 cases

Effect of chemotherapy on the larval mass and the long-term course of alveolar echinococcosis

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