Trichinosis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Danitza Lukac

Overview

The mainstay of therapy for trichinosis are anthelmintics drugs such as albendazole or mebendazole.

Medical therapy

  • Treatment for asymptomatic, abortive and mild patients:
    • Administration of anthelmintics
    • Administration of steroids if needed.
  • Treatment for pronounced and severe patients:
    • Hospitalization
      • Compulsory for severe cases
    • Administration of steroids, anthelmintics and analgesics.
    • Administration of fluids and electrolytes[1]
Trichinosis Anthelmintics Treatment
Drug Adult and Pediatric Dose
Albendazole 400 mg twice a day by mouth for 8 to 14 days
Mebendazole 200 to 400 mg three times a day by mouth for 3 days, then 400 to 500 mg three times a day by mouth for 10 days
  • Prompt treatment with antiparasitic drugs can help prevent the progression of trichinellosis by killing the adult worms and so preventing further release of larvae.
  • Once the larvae have become established in skeletal muscle cells, usually by 3 to 4 weeks post infection, treatment may not completely eliminate the infection and associated symptoms.
  • Treatment with either mebendazole or albendazole is recommended.
  • If treatment is not initiated within the first several days of infection, more prolonged or repeated courses of treatment may be necessary.
  • Both drugs are considered relatively safe but have been associated with side effects including bone marrow suppression.
  • Patients on longer courses of therapy should be monitored by serial complete blood counts to detect any adverse effects promptly and discontinue treatment.
  • Albendazole and mebendazole are not approved for use in pregnant women or children under the age of 2 years.
  • In addition to antiparasitic medication, treatment with steroids such as prednisone may be used to relieve muscle pain associated with larval migration.[2]

References

  1. Gottstein B, Pozio E, Nöckler K (2009). "Epidemiology, diagnosis, treatment, and control of trichinellosis". Clin Microbiol Rev. 22 (1): 127–45, Table of Contents. doi:10.1128/CMR.00026-08. PMC 2620635. PMID 19136437.
  2. Trichinellosis. CDC. http://www.cdc.gov/parasites/trichinellosis/health_professionals/index.html#tx. Accessed on January 26, 2016

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