Efficacy and Safety of Single and Double Doses of Ivermectin versus 7-Day High Dose Albendazole for Chronic Strongyloidiasis 英文参考文献.docVIP

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Efficacy and Safety of Single and Double Doses of Ivermectin versus 7-Day High Dose Albendazole for Chronic Strongyloidiasis 英文参考文献.doc

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Efficacy and Safety of Single and Double Doses of Ivermectin versus 7-Day High Dose Albendazole for Chronic Strongyloidiasis 英文参考文献

EfficacyandSafetyofSingleandDoubleDosesof Ivermectinversus7-DayHighDoseAlbendazolefor ChronicStrongyloidiasis YupinSuputtamongkol1*,NalineePremasathian1,KidBhumimuang1,DuangdaoWaywa1 ,Surasak Nilganuwong1,EkkapunKaruphong1,ThanomsakAnekthananon2,DarawanWanachiwanawin3, SaowalukSilpasakorn1 1Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, 2Department of Preventive and Social Medicine, Faculty of MedicineSirirajHospital,MahidolUniversity,Bangkok,Thailand,3DepartmentofParasitology,FacultyofMedicineSirirajHospital,MahidolUniversity,Bangkok,Thailand Abstract Background:Strongyloidiasis,causedbyanintestinalhelminthStrongyloidesstercoralis,iscommonthroughoutthetropics. Itremainsanimportanthealthproblemduetoautoinfection,whichmayresultinhyperinfectionanddisseminatedinfection in immunosuppressed patients, especially patients receiving chemotherapy or corticosteroid treatment. Ivermectin and albendazoleareeffectiveagainststrongyloidiasis.However,theefficacyandthemosteffectivedosingregimenaretobe determined. Methods:Aprospective,randomized,openstudywasconductedinwhicha7-daycourseoforalalbendazole800mgdaily was compared with a single dose (200 microgram/kilogram body weight), or double doses, given 2 weeks apart, of ivermectin in Thai patients with chronic strongyloidiasis. Patients were followed-up with 2 weeks after initiation of treatment,then1month,3months,6months,9months,and1yearaftertreatment.Combinationofdirectmicroscopic examinationoffecalsmear,formol-etherconcentrationmethod,andmodifiedKogaagarplateculturewereusedtodetect strongyloides larvae in two consecutive fecal samples in each follow-up visit. The primary endpoint was clearance of strongyloideslarvaefromfecesaftertreatmentandatoneyearfollow-up. Results:Ninetypatientswereincludedintheanalysis(30,31and29patientsinalbendazole,singledose,anddoubledoses ivermectingroup,respectively).Allexceptonepatientinthisstudyhadatleastoneconcomitantdisease.Diabetesmellitus, sy