Long Term Eradication Rate of Mebendazole Therapy for Strongyloidiasis

Abstract

We treated 245 strongyloidiasis patients with 7 schedules of mebendazole (MBZ) and obtained the eradication rates at 8 months to 2 years after the final treatment as described follows; MBZ (100 mg) was given twice a day orally. [Square bracket shows incidence of liver disfunction.] 1) The eradication rates at 2 years after single course of MBZ therapy for 28 days and a combination therapy (thiabendazole 500 mg powder form three times daily for 5 days followed by MBZ in powder form for 9 days, repeated once) were 93.8% (15 of 16 patients), [71.4%] and 100.0% (16/16), [50.0%]. 2) The eradication rates at 8-15 months after using MBZ alone in varying dosages were as follows: a) MBZ powder was administered for 5 days and was then repeated 1, 3 and 4 weeks later: 87.1 (27/31), [51.1%]. b) MBZ powder was given for 5 days and repeated 1 and 3 weeks later: 100.0% (7/7), [30.8%]. c) MBZ powder was administered for 4 days and repeated 1, 3 and 4 weeks later: 96.3% (26/27), [57.8%]. d) MBZ in tablet form was given for 4 days and repeated 1, 3 and 4 weeks later: 89.6% (43/48). [66.2%]. e) MBZ in tablet form was administered for 4 days and repeated 1 week later: 69.2% (9/13), [25.0%]. As described above, although the incidence of liver disfunction in the 4-day with 2-course therapy was lower than the other schedules, the eradication rate was lower. From these results, MBZ should be given to strongylodiasis patient for 4 days and repeated once, or for 3 days and repeated two or three times with 1 to 2 weeks intervals.

Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart

“…Among other benzimidazole compounds, mebendazole causes a high incidence of liver dysfunction, while albendazole does not provide an adequate eradication effect. [6][7][8][9] A promising new agent, ivermectin, has been recently introduced and shown to be effective against certain nematodes in Japan. Merck, the pharmaceutical company that manufactures this drug, has been supplying it free of charge since 1987 for the treatment of onchocerciasis.…”

Strongyloides ratti: In Vitro and In Vivo Activity of Tribendimidine

“…), there are only a few drugs available for the treatment and control of strongyloidiasis [6] . Albendazole and mebendazole were found to be safe, but multiple treatment courses repeated over several weeks were required to achieve acceptable cure rates [7] . Another benzimidazole, thiabendazole, is highly efficacious (two treatment courses of 25–50 mg/kg are commonly given for 3–4 days 2 weeks apart), but severe adverse events, including liver dysfunction and neuropsychiatric symptoms, have been observed [8] .…”

Comparison of anthelmintic effects of two doses of ivermectin on intestinal strongyloidiasis in patients negative or positive for anti-HTLV-1 antibody

“…We have used thiabendazole, mebendazole, and albendazole for treatment but believed that ivermectin was the safest drug. [10][11][12] The anthelmintic effect of ivermectin was equivalent to that of thiabendazole. 13 Ivermectin was approved by the Japan …”