Utilidad del albendazol/quinfamida en el tratamiento de la fase intestinal de la infección por Trichinella spiralis en modelo murio / Utility of abendazole/quinfamide in the treatment ofintestinal phase of infection in murine model Trichinella spiralis

La triquinelosis es una enfermedad parasitaria ocasionada por el nematodo Trichinella spiralis. Actualmente el tratamiento utilizado para la triquinelosis es la administración de albendazol o mebendazol. Estos medicamentos son efectivos contra el parásito, solo si se administran por periodos prolongados; sin embargo existe el inconveniente de que pueden causar efectos adversos en el hospedero. El objetivo de este trabajo fue evaluar el efecto terapéutico del medicamento OXAL® (albendazol/quinfamida) contra la infección por T. spiralis en modelo murino, durante la fase intestinal de la infección (1 y 7 días) por un periodo de 3 días. Los resultados obtenidos mostraron que la administración de OXAL® durante 3 días, tuvo eficacia terapéutica durante la fase intestinal, ya que no se obtuvo carga parasitaria en el grupo con 1 día de infección, y la obtenida en el grupo con 7 días de infección tuvo una disminución significativa respecto al control, p < 0.05

Trichinellosis is a parasitic disease caused by the nematode Trichinella spiralis. Currently the treatment for Trichinellosis includes the administration of albendazole or mebendazole. These drugs are effective against the parasite, only if administered for prolonged periods; however there is a drawback that can cause adverse effects on the host. The aim of this study was to evaluate the therapeutic efficacy OXAL® (albendazole/quinfamide) against infection by T. spiralis in mice during the intestinal phase of the infection (1, and 7 days) for a period of 3 days. The results showed that administration of OXAL® for 3 days, had effective therapy for intestinal phase, since there was no parasitic load in the group with 1 day of infection, and the obtained in the group with 7 days of infection showed a significant decrease with regard to control, p <0.05

Acute Drug-Induced Hepatitis Caused by Albendazole

Albendazole binds to parasite's tubulin inhibiting its glucose absorption. Its common adverse effects are nausea, vomiting, constipation, thirst, dizziness, headache, hair loss and pruritus. Although mainly metabolized in the liver, abnormal liver function tests were a rare adverse effect during clinical trials and we found no literature about albendazole-induced hepatitis requiring admission. This patient had a previous history of albendazole ingestion in 2002 resulting in increase of liver function tests. And in 2005, the episode repeated. We evaluated the patient for viral hepatitis, alcoholic liver disease, and autoimmune hepatitis, but no other cause of hepatic injury could be found. Liver biopsy showed periportal steatosis and periportal necrosis. The initial abnormal liver function test improved only with supportive care. These findings and the Roussel Uclaf Causality Assessment Method of the Council for International Organizations of Medical Sciences (RUCAM/CIOMS) score of 9 are compatible with drug-induced hepatitis so we report the case of this patient with a review of the literature.

Albendazole versus metronidazole in the treatment of patients with giardiasis in the Islamic Republic of Iran

We examined the therapeutic effects of albendazole compared to metronidazole in 120 patients with giardiasis in Hamdan. Patients were randomized to receive albendazole [400 mg, once daily for 5 days] or metronidazole [250 mg, 3 times a day for 5 days]. Demographic data of the patients, results of stool for Giardia trophozoites before and after treatment, and drug side- effects were recorded. After treatment 6 [10.0%] of the albendazole group had trophozoites compared with 14 [23.3%] of metronidazole group [P < 0.05]. Patients in the albendazole group had fewer side- effects while 43.3% of the metronidazole group experienced a metallic taste and 35.0% experienced loss of appetite. Albendazole is an easy, safe and effective treatment for giardiasis

Prevalence of strongyloides in Northern Thailand and treatment with ivermectin vs albendazole.

The stools of 697 cases were examined by agar plate technique at Tambon Makam Luang, Sun Pa Tong district, Chiang Mai; there were Strongyloides stercoralis 15.9%,Opisthorchis viverrini 5.1%, intestinal fluke 0.1%. Treatment with ivermectin 78 cases and albendazole 33 cases of strongyloidiasis gave cure rates at 98.7% and 78.7%, respectively. Alkaline phosphatase in some patients were increased at mild level after treatment. Side effects in ivermectin group were anorexia, nausia, diarrhea, diffuse itching and drowsiness; and in albendazole group were nausia and diarrhea. The efficacy of single dose and mild side effects suggest ivermectin as drug of choice for strongyloidiasis treatment.

Evaluación de la nitazoxanida en dosis única y por tres días en parasitosis intestinal / Nitazoxanide vs albendazole against intestinal parasites in a single dose and for three days

OBJETIVO: Evaluar la utilidad de nitazoxanida en dosis habitual con esquema de tres días y en dosis única, para la erradicación masiva de parásitos intestinales en la población pediátrica, comparando su efecto con el del albendazol en dosis única. MATERIAL Y MÉTODOS: Se realizó un ensayo clínico aleatorizado, en tres comunidades rurales de la región central de México, durante el periodo 2001-2003, para incluir tres posibles alternativas de tratamiento en 786 sujetos de entre 5 y 11 años de edad, de los cuales 92 tuvieron un examen parasitológico positivo (15.1 por ciento). El grupo 1 incluyó 27 pacientes que recibieron 400 mg de albendazol en dosis única; el grupo 2 incluyó 34 pacientes a quienes se administró nitazoxanida en dosis de 15 mg/kg/día durante tres días consecutivos; y el grupo 3 incluyó 31 pacientes que recibieron 1.2 g de nitazoxanida en dosis única. Se evaluó diferencia de proporciones mediante prueba exacta de Fisher. RESULTADOS: No existieron diferencias estadísticamente significativas en la efectividad de los tres esquemas de tratamiento: (80.5 por ciento) con albendazol, comparado con las dos alternativas adicionales de nitazoxanida (67.6 por ciento y 71 por ciento, respectivamente). Se observó una mayor prevalencia de efectos secundarios con nitazoxanida por kg /día (26.5 por ciento) y en dosis única (32.2 por ciento), en comparación con la dosis única de albendazol (7.4 por ciento). CONCLUSIONES: Las evidencias en cuanto a la efectividad y elevada prevalencia de efectos secundarios de la nitazoxanida no justifican aún su utilización como quimiopreventivo masivo para el control de parasitosis intestinal en áreas endémicas. En países con elevada prevalencia de parasitosis intestinal las medidas de prevención primaria que continúan vigentes, y que deben priorizarse, están relacionadas con sanidad pública, introducción de agua potable y drenaje, cloración de agua y manejo adecuado de excretas de animales domésticos, así como educación para la salud.

Comparison of ivermectin and albendazole treatment for gnathostomiasis.

Comparative treatment of ivermectin in 21 patients (Group 1) and albendazole in 49 patients (Group 2) of gnathostomiasis gave the cure at 95.2% and 93.8% respectively. The ELISA OD and eosinophil counts were reduction after treatment. Side effects in ivermectin were hypotention, dizziness, weakness and diuresis; and side effects of albendazole were nausia, dizziness and increased alkaline phosphatase in two cases. Ivermectin should be an effective drug againts gnathostomiasis and more convenient in treatment single dose.

Changes of liver functions after albendazole treatment in human gnathostomiasis.

Ninety-eight out-patients of the Hospital for Tropical Diseases, Bangkok with clinical diagnosis of cutaneous gnathostomiasis were studied. All patients were treated with albendazole at a dosage of 400 mg (two tablets) twice daily for 14 days. They were seen periodically on day 0, day 14, day 28, day 195 and 1 year after treatment with laboratory investigations for any side effects of the treatment. There was a statistically significant increase of total protein, albumin, alkaline phosphatase (ALP), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values when comparing the different periods. The abnormal results are clearly indicated in AST and ALT values (liver enzyme) especially on day 14 both male and female patients had highest levels. No significant association with time was found in ALP value.

Polirradiculoneurite e neurocisticercose: relato de caso / Polyradiculoneuretis and neurocysticercosis: a case report

Relata-se o caso de doente com forma hidrocefálica e meningoencefalítica de neurocisticercose que, na primeira semana de tratamento com albendazol, desenvolveu simultaneamente polirradiculoneurite e síndrome de hipertensao intracraniana. Sao relacionados vários agentes etiológicos encontrados na literatura associados à polirradiculoneurite. Comenta-se sobre a possível fisiopatogenia desta entidade na vigência de cisticercose. Faz-se mençao a outro caso que apresentou polirradiculoneurite, do tipo síndrome de Guillain-Barré, como única manifestaçao de provável cisticercose de sistema nervoso. No caso apresentado, além da própria neurocisticercose, o stress cirúrgico e aquele relativo à gravidade do quadro clínico, um possível efeito colateral do albendazol - ou, até mesmo, uma simples coincidência - podem ser considerados como fatores relacionados à presença de polirradiculoneurite nesse doente.

Estudio cariométrico del epitelio lingual de fetos de ratas tratadas con albendazol durante la preñez / Kariometric study of the epithelium of the tongue in rat fetuses treated with albendazole during pregnancy

La administración de albendazol (5mg/kg/día) a ratas Wistar en el 9º, 10º y 11º día de preñez, causó retardo de crecimiento intrauterino de fetos y placentas y disminución de la longitud de los cordones umbilicales. El epitelio de la mucosa lingual reveló disminución de espesor, con células mayores y menos numerosas. La región dorsal posterior de la mucosa lingual de los fetos del grupo tratado, no presentó queratina. El epitelio de la región ventral de la mucosa lingual no presentó capas granulosa ni córnea. Los resultados obtenidos mediante métodos cariométricos permiten sugerir que el epitelio de la mucosa lingual de los fetos del grupo tratado con albendazol, presenta aspectos de inmadurez y retardo de la diferenciación celular.

A randomised multicentre study to compare the safety and efficacy of albendazole and metronidazole in the treatment of giardiasis in children.

A randomised control multicentre study to compare the safety and efficacy of albendazole and metronidazole in the treatment of giardiasis in children is reported. One hundred and fifty children of either sex (age range: 2-10 years) were randomised to receive either a single dose of 400 mg of albendazole suspension, or 22.5 mg/kg/day of metronidazole in 3 divided doses for 5 consecutive days. At the end of therapy, majority of children in both treatment groups were symptom free. Two days after completion of therapy, 97% of children in both treatment groups were giardia free in the stools. Side effects were noted in 3 children in the albendazole group, and in 20 children in the metronidazole group. We conclude that albendazole suspension is as effective as metronidazole in the treatment of giardial infection in children. It is safe and has fewer side effects as compared to metronidazole.

Albendazole therapy for neurocysticercosis.

Based on clinical evaluation and computed tomography (CT) of the brain, 30 cases of neurocysticercosis were diagnosed. Diagnosis was supported by presence of histopathologically proven subcutaneous cysticerci in 12 cases. Three primary neurological syndromes were established i.e. epilepsy in 22 cases, increased intracranial tension in 6 cases and meningoencephalitis in 2 cases. Albendazole was administered orally in a dose of 15 mg/kg bodyweight/day for 30 days without prophylactic steroids. Follow up CT study at 3 months and 12 months revealed complete regression of all lesions in 2 cases, partial regressions in 14 cases and change in morphology in 4 cases. Transient appearence of fresh subcutaneous cysticerci as a side effect of therapy was noted in 4 cases. Albendazole, though acting slow, is considered a suitable alternative to praziquantel in medical management of parenchymal neurocysticercosis.

Tratamiento de la neurocisticercosis con albendazol. Experiencia en Medellín, Colombia

Se evaluó la eficacia del albendazol en el tratamiento de 20 pacientes con neurocisticercosis, sin complicaciones graves y con lesiones quísticas en parenquima cerebral, que no tomaran el medi de contraste, por medio de tomografía computadorizada. Todos los casos tuvieron prueba de ELISA positiva para anticuerpos contra cisticercos, en suero o en líquido cefalorraquídeo. Los pacientes fueron hospitalizados durante el tratamiento. Este consistió en albendazol por vía oral a la dosis de 15 mg/kg/día, subdividido en dos tomas por día, durante ocho días. No se usaron esteroides de rutina, pero fueron necesarios en tres pacientes. La mayoría de los casos recibieron concomitantemente tratamiento antiepiléptico. Los pacientes fueron seguidos entre seis meses y dos años. El principal criterio de eficacia fue la comparación de la tomografía computarizada pretratamiento y a los seis meses; se hizo además evaluación clínica e inmunológica. El número de quistes existentes en los 20 pacientes se redujo de 239 a 119 (50 por ciento de reducción). En siete casos (35 por ciento) hubo desaparición de todos los quistes. En siete pacientes (35 por ciento) el número de quistes se redujo. En los seis pacientes restantes (30 por ciento) no hubo cambio en el número de quistes. En los 13 casos que permanecieron con quistes, hubo moderada reducción del tamaño en 11 (promedio inicial 12.3 mm y promedio final 9.6 mm). En los dos pacientes restantes los quistes permanecieron iguales. En total se observó que la reducción promedio del tamaño de los quistes fue de 49 por ciento en los 20 pacientes. Se observaron efectos colaterales durante el tratamiento en el 60 por ciento de los casos

Albendazole stimulates outward migration of Gnathostoma spinigerum to the dermis in man.

Human gnathostomiasis is characterized by space-occupying inflammatory lesions and/or hemorrhage as a result of the migration of, very often, a single larva of Gnathostoma spinigerum. Intermittent cutaneous migratory swellings occurring over years is the most common manifestation and the rare cerebral invasion may be fatal. There are currently no effective anthelminthics for this infection. During a double-blind randomized placebo control trial evaluating the efficacy of albendazole in cutaneous gnathostomiasis at a dosage of 400 mg twice daily for two weeks, it was observed that gnathostome larvae tended to migrate outward as a result of the treatment so that they could be recovered by excisional biopsy or by picking with a needle. In the placebo-treated group (N = 40), no such migration was observed during the 8,470 patient-days of follow-up while in the albendazole-treated group (N = 41) there was one worm in an excisional biopsy done on day 16 and two worms were removed from the skin by the patients themselves on days 8 and 0. Assuming that the period of drug exposure of the gnathostomes was the 14 days of albendazole administration plus another washout period of 7 days (equivalent to 20 half-lives of the active detectable metabolite), the total patient-days of albendazole exposure was 830. The rate of outward migration of gnathostomes in the drug treated group (3 per 830 patient-days) was significantly (p < 0.0001) higher than in the placebo group (0 per 8,470 patient-days).(ABSTRACT TRUNCATED AT 250 WORDS)