Plasma and CSF Levels of Albendazole and Praziquantel in Patients with Neurocysticercosis

Jung, Hyejin; Hurtado, Marcela; Sánchez, Mónica; Medina, Marco T.; Sotelo, Julio

doi:10.1097/00002826-199012000-00008

Cited by 69 publications

(27 citation statements)

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“…Survival of cysts in brain tissue may be explained by lower concentrations of the drug or reduced immune efficacies in the central nervous system because of the blood-brain barrier. 27 Pig brain is not commonly eaten raw; thus, it is highly improbable that cysts that survive only in the brain will be ingested and perpetuate the cycle.…”

Section: Resultsmentioning

confidence: 99%

Time-response curve of oxfendazole in the treatment of swine cysticercosis.

González¹,

Falcón²,

Gavidia³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. Human Taenia solium cysticercosis is a major cause of epilepsy in developing countries, and porcine infection causes widespread economic losses because of infested pork. Recently, the use of oxfendazole (OFZ) for porcine cysticercosis provided, for the first time, an effective, single-dose treatment. We performed a controlled study to determine the time required between treatment with a single dose of OFZ and the death of cysticerci to define its applicability as preslaughter treatment or as a field control measure. Twenty naturally infected pigs were included in this study. Sixteen received a single dose (30 mg/kg) of OFZ, and were killed in groups of four at one, two, four, and 12 weeks after treatment. Four untreated controls were killed at week 12. No adverse reactions to OFZ were noted. A clear decrease in viability and number of cysts was evident after the first week after therapy, but even at week 4 some viable cysticerci were found in all samples. Twelve weeks after treatment, all meat appeared clear and only minuscule scars remained, except in one animal that had viable brain cysts. This study confirms the efficacy of a single dose of 30 mg/kg of OFZ for porcine cysticercosis but demonstrates that preslaughter treatment of pigs with OFZ will not be useful in controlling cysticercosis. The inclusion of porcine treatment with OFZ in mass cysticercosis control programs is, however, highly promising because it is a simple, effective, inexpensive, and potentially sustainable method for decreasing the porcine reservoir of cysticercosis in disease-endemic countries.

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Section: Resultsmentioning

confidence: 99%

Time-response curve of oxfendazole in the treatment of swine cysticercosis.

González¹,

Falcón²,

Gavidia³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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“…Of the two, only albendazole has been used in children with NLM. In addition, albendazole appears to have the more favorable pharmacologic profile, with good absorption, high serum concentrations of the active metabolite, good penetration across the blood-brain barrier, and minimal toxicity (11,26).…”

Section: Visceral and Neural Larva Migransmentioning

confidence: 99%

Baylisascariasis

2005

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SUMMARY The raccoon roundworm, Baylisascaris procyonis, is the most common and widespread cause of clinical larva migrans in animals. In addition, it is increasingly recognized as a cause of devastating or fatal neural larva migrans in infants and young children and ocular larva migrans in adults. Humans become infected by accidentally ingesting infective B. procyonis eggs from raccoon latrines or articles contaminated with their feces. Two features distinguish B. procyonis from other helminthes that cause larva migrans: (i) its aggressive somatic migration and invasion of the central nervous system and (ii) the continued growth of larvae to a large size within the central nervous system. Typically, B. procyonis neural larva migrans presents as acute fulminant eosinophilic meningoencephalitis. Once invasion of the central nervous system has occurred, the prognosis is grave with or without treatment. To date, despite anthelmintic treatment of cases of B. procyonis neural larva migrans, there are no documented neurologically intact survivors. Epidemiologic study of human cases of neural larva migrans demonstrate that contact with raccoon feces or an environment contaminated by infective eggs and geophagia or pica are the most important risk factors for infection. In many regions of the United States, increasingly large populations of raccoons, with high rates of B. procyonis infection, live in close proximity to humans. Although documented cases of human baylisascariasis remain relatively uncommon, widespread contamination of the domestic environment by infected raccoons suggests that the risk of exposure and human infection is probably substantial. In the absence of early diagnosis or effective treatment, prevention of infection is the most important public health measure.

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“…Serum levels of phenytoin and carbamazepine may also be lowered as the result of simultaneous praziquantel administration (12). Albendazole has better penetration into cerebrospinal fluid, its concentrations are not affected when given with steroids (61,62), and it is cheaper than praziquantel. Table 2 summarizes most trials of antiparasitic therapy for neurocysticercosis.…”

Section: Vol 15 2002 Guidelines For Treatment Of Neurocysticercosismentioning

confidence: 99%

Current Consensus Guidelines for Treatment of Neurocysticercosis

et al. 2002

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Taenia solium neurocysticercosis is a common cause of epileptic seizures and other neurological morbidity in most developing countries. It is also an increasingly common diagnosis in industrialized countries because of immigration from areas where it is endemic. Its clinical manifestations are highly variable and depend on the number, stage, and size of the lesions and the host's immune response. In part due to this variability, major discrepancies exist in the treatment of neurocysticercosis. A panel of experts in taeniasis/cysticercosis discussed the evidence on treatment of neurocysticercosis for each clinical presentation, and we present the panel's consensus and areas of disagreement. Overall, four general recommendations were made: (i) individualize therapeutic decisions, including whether to use antiparasitic drugs, based on the number, location, and viability of the parasites within the nervous system; (ii) actively manage growing cysticerci either with antiparasitic drugs or surgical excision; (iii) prioritize the management of intracranial hypertension secondary to neurocysticercosis before considering any other form of therapy; and (iv) manage seizures as done for seizures due to other causes of secondary seizures (remote symptomatic seizures) because they are due to an organic focus that has been present for a long time

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Plasma and CSF Levels of Albendazole and Praziquantel in Patients with Neurocysticercosis

Cited by 69 publications

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Time-response curve of oxfendazole in the treatment of swine cysticercosis.

Time-response curve of oxfendazole in the treatment of swine cysticercosis.

Baylisascariasis

Current Consensus Guidelines for Treatment of Neurocysticercosis

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