Treatment of Strongyloidiasis with Mebendazole and Its Combination with Thiabendazole

Abstract

Although Strongyloides stercoralis (S. stercoralis) infection rate in Okinawa Prefecture was less than 2% by the traditional method, it has been proven to be 6.2% by the new technique--agar plate method. Thiabendazole has strong activity to eradicate the organism, but it is well known that the rate of severe side effects is extremely high. Therefore, we attempted to evaluate the new treatment for the infection by mebendazole and its combination with thiabendazole. The reason for use of the drug is based on the reports of successful treatment of S. stercoralis infection in humans with the mild and infrequent side effects produced by the drug. Thirty three patients were orally given mebendazole 100 mg twice daily for 28 days. Twenty six patients were given thiabendazole 500 mg thrice daily for 5 days and after that, mebendazole 100 mg twice daily for 9 days. This combination therapy was repeated twice. The following results were obtained: 1) Out of a total of 59 patients, the cure rate was 83.3% (20/24) in single use of mebendazole and 100.0% (22/22) in the combination therapy. 2) Constipation (9.1%) and headache (9.1%) were of relatively high incidence in the mebendazole group, but they were mild. Nausea (19.2%) and headache (15.4%) were observed in the combination therapy group and the drug was discontinued in 2 patients. 3) The incidence of the elevation of S-GOT, S-GPT was noted in 71.4% (20/28) for the mebendazole group and 52.2% (12/23) for combination therapy group. All 13 patients of the mebendazole group were negative in lymphocyte stimulation test for mebendazole.(ABSTRACT TRUNCATED AT 250 WORDS)

Morbidity Associated with Chronic Strongyloides stercoralis Infection: A Systematic Review and Meta-Analysis

“…Quality was assessed at study level and was expressed as low (in case a single or two stars were assigned to the study), high (three or four stars), or very high (five to six stars). 20 i Tanzania Children Baermann 333 n n y y y Shikiya et al 22 i Japan Adults Stool culture 23 n y n n n Zaha et al 27 i Japan Adults Stool culture 299 y y n y y Oyakawa et al 21 i Japan Adults Stool culture 161 y y n y y Shikiya et al 24 i Japan Adults Stool culture 54 y y n y y Shikiya et al 23 i…”

Ivermectin versus albendazole or thiabendazole for Strongyloides stercoralis infection

“… Schaffel 2000 No control group. Shikiya 1990 Participants not randomized. Shikiya 1991 Participants not randomized.…”

Efficacy of Ivermectin against Strongyloides Stercoralis in Humans.

“…Thiabendazole is strongly active in eradicating the organism, but it is well known that the rate of severe side effects is extremely high (4)(5)(6). Mebendazole is also active against S. ster coralis (7,8), but a high incidence of liver disfunction was shown in our previous studies (9,10). Ivermectin (IVM) has recently been found to be safe and effective for treatment of human onchocerciasis (ll-14) and lymphatic filariasis (15), but there are only two published reports concerning the efficacy of IVM against S. ster coralis in humans (16, 17).…”