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Oxantel pamoate–albendazole for infection with soil-transmitted helminths

Treatment with oxantel pamoate–albendazole resulted in higher cure and egg-reduction rates for T. trichiura infection than the rates with standard therapy, reports this week's issue of the New England Journal of Medicine.

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Infections with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) are widespread and often occur concomitantly.

These parasitic-worm infections are typically treated with albendazole or mebendazole, but both drugs show low efficacy against Trichuris trichiura.

Albendazole is the drug of choice against hookworm.

In this double-blind trial conducted on Pemba Island, Tanzania, Dr Benjamin Speich and colleagues randomly assigned children, 6 to 14 years of age, to receive one of 4 treatments.

The treatments included oxantel pamoate at a dose of 20 mg per kilogram of body weight, plus 400 mg of albendazole, administered on consecutive days, oxantel pamoate at a single dose of 20 mg per kilogram, albendazole at a single dose of 400 mg, or mebendazole at a single dose of 500 mg.

The researchers assessed the efficacy and safety profile of oxantel pamoate–albendazole when used in the treatment of Trichuris trichiura infection, and concomitant soil-transmitted helminth infection.

Adverse events were reported by 31% of all children
Alimentary Pharmacology & Therapeutics

Efficacy was determined by means of assessment of the cure rate and egg-reduction rate.

The team assessed adverse events were 4 times after treatment.

Complete data were available for 458 children, of whom 450 were infected with T. trichiura, 443 with hookworm, and 293 with A. lumbricoides.

The team observed that the cure rate of Trichuris trichiura infection was significantly higher with oxantel pamoate–albendazole than with mebendazole, as was the egg-reduction rate.

The cure rate and the egg-reduction rate was significantly lower than the rates with mebendazole.

Oxantel pamoate had low efficacy against hookworm and A. lumbricoides.

Adverse events were reported by 31% of all children.

Dr Speich's team concludes, "Treatment with oxantel pamoate–albendazole resulted in higher cure and egg-reduction rates for Trichuris trichiura infection than the rates with standard therapy."

N Engl J Med 2014; 370:610-620
14 February 2014

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