The Hymenolepis diminuta-golden hamster (Mesocricetus auratus) model for the evaluation of gastrointestinal anticestode activity.

A novel laboratory anticestode assay was developed using Hymenolepis diminuta in the hamster. The commercial anticestode compounds, praziquantel, bunamidine, and niclosamide were active against patent infections of Hymenolepis diminuta in golden hamsters (Mesocricetus auratus) when given orally at 3.125, 100, and 200 mg/kg, respectively. The gastrointestinal nematode anthelmintics, cambendazole and mebendazole, were active at 50 mg/kg. Rafoxanide (fasciolicide) was active at 25 mg/kg, the lowest level tested. The coccidiostat, nicarbazin, was active at experimental levels (800 mg/kg and up). The anthelmintic-ectoparasiticide (endectocide), ivermectin, was inactive against the tapeworm at 0.5 mg/kg, as expected.

[Strongyloidosis. Part IX. Treatment]. / Wegorczyca (strongyloidosis). Czesc IX. Leczenie.

The treatment of chronic and massive (uncomplicated) and severe (complicated) disseminated strongyloidosis, was presented from the historical point of view. The sequence of achievements in regard of treatment of the gentian violet, dithiazine iodide, benzimidazoles (thiabendazole, mebendazole, albendazole, cambendazole), ivermectin and cyclosporin A, was described. The recommendations for treatment of strongyloidosis are also given.

Strongyloidiasis as an opportunistic infection in a HAM/TSP patient

Infection by human T-cell lymphotropic virus type I (HTLV-I) is associated with neurological diseases, malignancies, and other less commun pathologies. In addition, infection by HTLV-I has been implicated in some degree of immunological impairment. Some previous reports detected an association between HTLV-I infection and an increased rate of antibodies against S. stercoralis, as well as a higher frequency of S. stercoralis carrier state. Here, we report a case of a chronic, recurrent S. stercoralis parasitism in a patient infected by HTLV-I. The patient demonstrated evidence of immunosupression characterized by skin allergy to commun antigens, oral candidiasis and severe, recurrent diarrhea caused by S. stercoralis. The infection requires maintenance of supressive therapy to control diarrhea and its consequences. We postulate that S. stercoralis may act as an opportunistic agent in patients infected by HTLV-I.

Tratamento de parasitoses intestinais / Intestinal parasitosis treatment

Os autores apresentam um trabalho de revisão sobre tratamento de parasitoses intestinais, onde expõem de forma racional e adaptada ao nosso meio as parasitoses mais freqüentes. Também relatam os aspectos epidemiológicos e os métodos de diagnóstico laboratorial recomendados de acordo com o parasita. Fazem uma revisão detalhada das drogas antiparasitárias nos seus aspectos farmacológicos e apresentam uma proposta de conduta terapêutica em situações especiais como estrongiloidíase disseminada, neurocisticercose e na sub-oclusão intestinal por ascaridíase (au)

Disseminated Strongyloides stercoralis infection in an AIDS patient: The role of suppressive therapy

Patients with AIDS are prome to develop infections caused by opportunistic pathogens. Unusual agents, such as Stongyloides stercoralis, are being described in this syndrome, resulting in disseminated disease which is always severe and, in some cases, fatal. We describe a case of patient with AIDS and Strongyloides stercoralis infection involving the gastrointestinal tract and lungs. Therapy with thiabendazole for ten days led to resolution of the acute episode. Preventive therapy with 3g of thiabendazole once a week was then prescribed, and repeated fecal examinations were negative for larvae. Following discontinuation of treatment, however, the patient again had a positive fecal examination for Strongyloides stercoralis larvae, even though reinfection was considered to be very unlikely. The patient was retreated with a shorter course of therapy and once per week preventive therapy was reintroduced. After four months of follow-up, repeated fecal examinations were negative. When the treatment was changed to thiabendazole given once every two weeks, however, pulmonary Strongyloides stercoralis recurred. Subsequently, because of intolerance to thiabendazole, the patient was treated with cambendazole. The patient died three months later due to Pseudomonas aeruginosa pneumonia. Prolonged therapy for Strongyloides stercoralis infection may be necessary. Although further evaluation is needed, 3g of thiabendazole once a week may be adequate for this purpose. Cambendazole may be a useful alternative for disseminated Strongyloides stercoralis.

Benzimidazole resistance in cyathostomes in horses in the Ukraine.

The efficacy of treatment with cambendazole was tested in 1-year-old horses on a farm in Dubrovka, Ukraine. Thirty-five horses were treated. Their egg output was compared on the day of treatment and 14 days later with that of 33 untreated horses. Before treatment the mean number of eggs g-1 faeces was 614 in the controls and 766 in horses that had been treated. After 14 days the mean egg output in the controls was 580 and in the treated horses 369. This means a reduction of 54.5%. Only cyathostome larvae could be cultured from faeces collected after treatment. It can be concluded that benzimidazole resistance in cyathostomes is present in the Ukraine.

Control of cambendazole-resistant small strongyles (Population S) with oxibendazole in a pony band: an 8 year field test (1984-1992).

Studies in a band of ponies harboring Population S benzimidazole-resistant small strongyles were initiated in 1974 and have continued for 18 years. Treatment (bimonthly) was with cambendazole for the first 4 years and with oxibendazole (OBZ) for the next 14 years. Data on the first 10 years have been published. The present investigation includes the last 8 years (4 October 1984-11 September 1992), which are the seventh through fourteenth years, of treatment with OBZ. Pre- and posttreatment mean counts of strongyle eggs (epg) and larvae (lpg) per gram of feces were determined biweekly during the current study to monitor the efficacy of OBZ. The average annual percent reductions of epg counts effected by OBZ treatments were 51%, 53%, 38%, 38%, 39%, 28%, 40%, and 19% for the seventh through fourteenth years, respectively. Similar levels of reductions were observed for lpg counts. Although OBZ was initially highly effective on this population of small strongyles, epg and lpg counts gradually declined, but have remained more or less constant since the fifth year of research. However, reductions of the counts were the lowest for the last year of the study.

Controlled tests of activity of several antiparasitic compounds against natural infections of Haemonchus contortus and other helminths in lambs from a flock established in 1962.

Antiparasitic activity of several compounds was evaluated over a long period (about 25 years) in the same flock of sheep. Haemonchus contortus was of special interest, including its relation to drug resistance, especially to thiabendazole and other benzimidazoles, in addition to phenothiazine. Eleven compounds were evaluated in 15 controlled tests, done between 1966 and 1989 in naturally infected lambs (n = 145) born and raised on the same pasture. Sheep were first placed on the pasture in 1962, and a few more were added thereafter. Internal parasites in these sheep were classified in 3 general categories: indeterminate exposure to parasiticides; H contortus, resistant to thiabendazole; and H contortus, resistant to phenothiazine. The parasitic infections probably became more homogeneous after several years because of few introductions of outside sheep after initial establishment of the flock. Activity against naturally acquired internal helminths was evaluated for cambendazole (CBZ: dosage, 20 mg/kg of body weight), fenbendazole (FBZ: 5 or 7.5 mg/kg), mebendazole (MBZ: 10 mg/kg); oxfendazole (OFZ: 3.5 or 10 mg/kg), oxibendazole (OBZ: 10 mg/kg); parbendazole (PBZ: 15 mg/kg), phenothiazine (PTZ: 550 mg/kg); pyrantel pamoate (PRT: 25 mg base/kg), tetramizole (TET: 15 mg/kg); thiabendazole (TBZ: 30 or 44 mg/kg), and trichlorfon (TCF: 100 mg/kg). Thiabendazole was used more often (9 tests) than the other compounds. Thiabendazole was more active against mature H contortus in later years than when first used in 1966, although it was never 100% effective. Efficacy against immature H contortus for TBZ did not exceed 86%. Activity against immature and mature stages of this parasite was good overall for the other benzimidazoles.(ABSTRACT TRUNCATED AT 250 WORDS)

The prevalence of anthelmintic resistance of horse strongyles in The Netherlands.

A survey to determine the prevalence of anthelmintic resistance of horse strongyles was carried out with 616 horses on 22 farms. The tested drugs were cambendazole, pyrantel pamaote and ivermectin. Based on egg count reduction tests the efficacy of cambendazole varied from 0% to 93% and of pyrantel from 93% to 100%. Ivermectin treatments were 100% effective on all farms. Larval cultures after cambendazole treatments revealed exclusively cyathostome larvae. After pyrantel treatments besides cyathostome larvae other types of larvae were also found. After ivermectin treatments only a few cyathostome larvae were observed. It can be concluded that benzimidazoleresistance of cyathostomes is very common and widespread in the Netherlands. This means that benzimidazoles and pro-benzimidazoles should be excluded for strategic use in horses.

Resistance of population-B equine strongyles to thiabendazole, oxfendazole, and phenothiazine (1981 to 1987).

Critical tests were completed on foals (n = 15) naturally infected with benzimidazole (BZ)-resistant population-B strongyles during the period between 1981 and 1987. Thiabendazole at a dosage of 44 mg/kg was tested in 8 foals, oxfendazole at 10 mg/kg was tested in 4 foals, and phenothiazine at 55 mg/kg, cambendazole at 20 mg/kg, and fenbendazole at 5 mg/kg were tested in 1 foal each. Efficacies of thiabendazole, cambendazole, and fenbendazole against the 5 species of BZ-resistant small strongyles (Cyathostomum catinatum, Cyathostomum coronatum, Cylicocylus nassatus, Cylicostephanus goldi, and Cylicostephanus longibursatus) were partial. Removals in the aggregate averaged 48%, 52%, and 68%, respectively, indicating continued resistance of the 5 species of small strongyles to thiabendazole, cambendazole, and fenbendazole. In contrast, oxfendazole was efficacious, removing an aggregate average of 95% of the 5 BZ-resistant species of small strongyles in the 4 foals. This apparent reversion to susceptibility to oxfendazole may be attributable to paucity of reference data (1 test foal) done in 1976. All 5 species of the BZ-resistant small strongyles had cross resistance to phenothiazine (38% aggregate removal), whereas 9 of the BZ-susceptible species were effectively (99%) removed. This suggests a similar mode of action between phenothiaznie and the BZ compounds.

Dissociation of the protective immune response in the mouse to Strongyloides ratti.

The generation of protective immunity by various stages in the life-cycle of Strongyloides ratti and the phases against which resistance is directed has been examined in murine strongyloidiasis. Mice were exposed to natural, complete infections, were treated with thiabendazole (which largely resembles the natural infection), were treated with cambendazole (which restricts infection to the larval stage), or infected directly by oral transfer of adult worms. Mice that were infected with infective larvae alone did not become resistant to infective larvae or the complete infection but were resistant to adult worms implanted directly into the gut. Mice exposed to adult worms alone were resistant to natural infections and adults worms implanted directly but were not resistant to infective larvae. On the other hand, mice that had received prior natural infections showed evidence of resistance to infective larvae, adult worms, and natural, complete infections. It is concluded that there is immunological cross-reactivity between infective larvae and adult worms but that under certain circumstances the infective larvae are able to evade the host's protective immune response.

The effects of thiabendazole, mebendazole and cambendazole in normal and immunosuppressed dogs infected with a human strain of Strongyloides stercoralis.

The effects of three benzimidazole anthelmintics in dogs infected with a human strain of Strongyloides stercoralis were investigated. Cambendazole, but not thiabendazole or mebendazole, abrogated the subsequent development of a patent infection when administered at the same time as infection to immunocompetent dogs. None of the drugs eradicated infection when given after the onset of patency in immunosuppressed animals, although worm burdens were greatly reduced in dogs treated with cambendazole. The implications of these findings for the treatment of patients with strongyloidiasis, particularly those with disseminated infections, are discussed.

Efficacy of four anthelmintics against benzimidazole-resistant cyathostomes of horses.

In order to confirm benzimidazole resistance as recommended at a workshop of the Commission of the European Communities the isolate 'E' of cyathostome strongyles originating from a stud where benzimidazole resistance had been demonstrated by egg hatch tests and by egg count reduction tests was investigated in two series of critical tests. Each of 11 foals reared strongyle-free was infected with 130,000 third stage cyathostome larvae. One animal remained untreated, two pairs of foals were treated with paste formulations of the (pro)benzimidazoles cambendazole (20 mg/kg bodyweight) or febantel (6 mg/kg bodyweight) and two groups of three foals were given pastes containing the non-benzimidazole drugs pyrantel pamoate (19 mg/kg bodyweight) or ivermectin (0.2 mg/kg bodyweight) either at 101 days (trial 1) or at 59 to 62 days (trial 2) after infection. Strongyles were counted in faecal samples collected daily between treatment and post mortem examination five or seven days later and worm burdens were counted in the intestinal contents and mucosal digests. Nine species of the cyathostome subfamily were found in the infected foals. The numbers of luminal stages were reduced by only 3.1 and 20.2 (mean 7.9) per cent by cambendazole and by 13.6 and 32.8 (mean 21.3) per cent by febantel in the individual animals. However, pyrantel pamoate (93.6 to 98.2, mean 96.3 per cent reduction) and ivermectin (100 per cent reduction) were highly effective. These trials provide the first report of benzimidazole resistant Cylicostephanus poculatus anywhere in the world and demonstrate (pro)benzimidazole resistance in seven other species for the first time in Europe.

Prevalence and control of benzimidazole-resistant small strongyles on German thoroughbred studs.

The prevalence of benzimidazole-resistant small strongyles was determined in a survey, conducted on 14 thoroughbred studs, which compared the faecal egg counts of groups of horses before and after treatment with the recommended doses of cambendazole (20 mg kg-1 b.w.) or febantel (6 mg kg-1 b.w.). Benzimidazole-resistant cyathostomes were found on all farms examined. Pyrantel pamoate (19 mg kg-1 b.w.), oxibendazole (10 mg kg-1 b.w.) and ivermectin (0.2 mg kg-1 b.w.) reduced the strongyle egg counts on these studs by 97-100% at 2 weeks post-treatment. However, 6 weeks after dosing the reduction of the strongyle egg output had decreased to an average of 67.8% (8.7-97.1%) with pyrantel pamoate and 51.2% (0-95.8%) with oxibendazole, whereas ivermectin still suppressed the egg counts by 98.2% (95-100%).

Avaliaçäo da atividade terapêutica do Albendazol em ratos experimentalmente infectados com Strongyloides venezuelensis / Evaluation of the therapeutic activity in rats experimentally infected with Strongyloides venezuelensis

Com a finalidade de demarcar mais precisamente o espectro de açäo do albendazol, foi estudada a atividade terapêutica desse anti-helmíntico em ratos experimentalmente infectados com Strongyloides venezuelensis, tendo sido usada, como termo de comparaçäo, a açäo do cambendazol e do mebendazol, dois outros benzimidazólicos. Os três compostos mostraram-se eficientes quando utilizadas doses únicas de 6,75 12,5, 25 e 50 mg/kg, pois motivaram desaparecimento total das formas adultas no intestino. Com a posologia de 5 mg/kg sucederam porcentagens médias de reduçöes dos números de vermes de 87%, 98% e 80%, respectivamente, como decorrência do emprego do albendazol, do cambendazol e do mebendazol, traduzindo superioridade da segunda droga citada