Treatment of Ascariasis in Children with Piperazine Adipate

Abstract

Summary A case of tinea circinata is described in a 10-day-old infant; the 19-year-old mother suffered from tinea capitis and tinea unguium. Three nurses attending the baby were infected.Trichophyton sulphureum was isolated from the baby and from his mother.Ringworm in infancy, tinea capitis in adults, and T. sulphureum infections are discussed and the literature is briefly reviewed.The incubation period of T. sulphureum infections is discussed with reference to these cases. REFERENCES Beare, J. M., and Cheeseman, E. A. (1951). Brit Great progress in the treatment of ascariasis was attained by the discovery of the anthelmintic properties of piperazine. Many of its derivatives-namely, the hydrate, citrate, and diphenylacetate-have been tried with a variable degree of success. Treatment with piperazine hydrate was first described by Fayard (1949), who treated about 2,000 adult cases with two 1.5-g. doses of piperazine (corresponding to 3.5 g. of piperazine hexahydrate)-one in the evening and the other the next morning. Of these cases, 70-95 % passed ascarides on the second and third days. As stool examinations were not carried out after treatment it is impossible to determine the exact cure rate in this series. White (1954) reported the successful treatment of three ascaris-infested children with piperazine hydrate. He used 68, 30, and 81 mg./kg. body weight a day respectively for seven to ten days. The worms were expelled on the second and third days. Brown (1954) treated 51 cases of ascariasis with a syrup containing piperazine hexahydrate, given for two to five days. He used. 1 g. a day for children weighing less than 60 lb. (27 kg.). He reported 100 % cure for those who were treated for five days, 87% cure for those treated for four days, 93% cure for those treated for three days, and 85 % cure in those treated for two days.Neurological side-effects, mostly in adults, have been reported following the administration of piperazine hydrate (White and Standen, 1953 ; Sims, 1953 (1) its anthelmintic effect is much greater than that produced by an equivalent weight of piperazine hydrate; (2) it is free of toxic side-effects; (3) it is stable on storage; (4) it has a high piperazine content; and (5) it has a pleasant acidulous taste and is free from odour.While these trials were in progress O'Brien (1954) reported briefly two cases of young children whom he treated for oxyuris infestation and in whom ascarides were also present. He gave 300 mg. of piperazine adipate twice daily for six days, and in both cases the drug appeared to be strikingly effective.Rearden (1954) also reported his experiences with piperazine adipate in the treatment of ascariasis in children and confirmed its efficacy. The dose used was 0.3 g. each day for each year of life in children up to 6 years -those over 6 were given 0.6 g. three times a day. Administration was continued for one week. All the children, save one, were completely cured. Present WorkPiperazine adipate was used in a series of cases in order to determine the most effective dos...