Recent Advances in the Use of Anthelmintics for Treating Nematode Infections / 감염과화학요법

The recent trends of parasitic infections in Korea include remarkable decreases of soil-transmitted nematode infections and elimination of lymphatic filariasis. In comparison, enterobiasis (pinworm infection) continues to be prevalent among children and the cases of zoonotic tissue-invading nematode infection are slightly increasing or they are being increasingly diagnosed. In addition, imported parasitoses continue to be problems from the clinical and public health points of view. In this review, the advances in the management and anthelmintic treatment of these nematode infections are briefly reviewed. Albendazole, mebendazole, thiabendazole, flubendazole, pyrantel pamoate, pyrvinium pamoate, oxantel pamoate, levamisole, ivermectin, and diethylcarbamazine are the examples of anti-nematode anthelmintics that are currently being used. Although several of these drugs are known to be broad-spectrum anthelmintics, selection of each drug should be done specifically for each nematode infection, and with consideration of the specific conditions of each patient and the purposes, for example, when performing individual or mass treatment. It is hoped that the chemotherapy regimens reviewed here will help physicians to treat their patients infected with nematode parasites.

Comparative studies on the efficacy of three anthelminthics on treatment of human strongyloidiasis in Okinawa, Japan.

A study was undertaken to compare the efficacy of three drugs in the treatment of uncomplicated strongyloidiasis in Okinawa, Japan. Two hundred and eleven patients with confirmed Strongyloides stercoralis infection were given either ivermectin, 6 mg in a single dose, albendazole, 400 mg/day for 3 days or pyrvinium pamoate, 5 mg/kg/day for 3 days. For each treatment, the same regimen was repeated once 2 weeks later. Efficacy was evaluated at 2 weeks, 6 months and 12 months after the second course of treatment. Each follow-up examination included a parasitological examination of z stool specimens, using the agar-plate culture method. Coprological cure was obtained in 65 of the 67 patients treated with ivermectin (97.0%), in 65 of the 84 patients treated with albendazole (77.4%) and only in 14 of the 60 patients who were given pyrvinium pamoate (23.3%). The cure rates were lower in males and in the patients with concurrent HTLV-1 infection. An epidemiological feature of Strongyloides infection in recent Okinawa might allow workers to evaluate the exact efficacy of the treatment for an extended period, over a year, without the possibility of reinfection from the environment.

Clinical observations on the use of pyrvinium pamoate in enterobiasis

Pyrvinium pamoate (Vanquin) was administered in a single dose of one teaspoonful for every 10 Kg. or 22 lbs. of body weight to 50 children ranging in age from 1-13 years found positive for Enterobius vermicularis ova by the scotch tape test. From the results of the study, it can be concluded that this dose given only once to the patient and the other members of the household at the same time insures 100 per cent cure with just one dose. The drug, besides its effectivity on pinworms, offers other advantages in the single oral dose and also the absence of toxic side effectsThere may still be no real answer to the pinworm problem, but for the present Pyrvinium pamoate serves as a suitable and effective drug against this annoying parasitic infestation - the pinworm. (Summary and Conclusions)