Ascariasis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]
Overview
Medical Therapy
All ascariasis infection (symptomatic and asymptomatic) should be treated with antimicrobial therapy.[1]
Antihelminthic Regimen for Ascariasis[1][2][3][4][5]
- Preferred regimen
- Albendazole 400 mg PO single dose. Albendazole dose for children between the ages of 1-2 years is 200 mg.
- Mebendazole 500 mg PO single dose or 100 mg bid for 3 days
- Alternative regimen
- Ivermectin 150 to 200 µg/kg PO single dose
- Nitazoxanide 500 mg bid for 3 days (adolescents and adults); 200mg bid for 3 days (children 4-11 yrs of age); 100mg PO bid for 3 days (children 1-3 yrs of age)
- Levamisole 150 mg PO single dose. The pediatric dose is 2.5 mg/kg PO daily
- Pyrantel Pamoate 11 mg/kg single dose PO - maximum 1.0 g
- Piperazine citrate 75 mg/kg qd for 2 days - maximum 3.5 g
Management of Intestinal obstruction
Intestinal obstruction due to ascariasis should be managed conservatively by:[1]
- Nasogastric decompression
- Fluid and electrolyte repletion
- Antihelminthic therapy once bowel motility is restored. Piperazine causes flaccid paralysis of the worms and this can help relieve the obstruction.
- Complete obstruction with inadequate decompression, lack of response within an interval of 24-48 hrs, volvulus, intussusception or perforation should be managed surgically.
References
- ↑ 1.0 1.1 1.2 Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.
- ↑ Centers for Disease Control and Prevention.https://www.cdc.gov/parasites/ascariasis/health_professionals/index.html#tx Accessed on the 6th of March, 2017.
- ↑ Romero Cabello R, Guerrero LR, Muñóz García MR, Geyne Cruz A (1997). "Nitazoxanide for the treatment of intestinal protozoan and helminthic infections in Mexico". Trans R Soc Trop Med Hyg. 91 (6): 701–3. PMID 9580117.
- ↑ Khuroo MS (1996). "Ascariasis". Gastroenterol Clin North Am. 25 (3): 553–77. PMID 8863040.
- ↑ Kliegman, Robert; Stanton, Bonita; St. Geme, Joseph; Schor, Nina (2016). "Chapter 291:Ascariasis (Ascaris lumbricoides)". Nelson Textbook of Pediatrics Twentieth Edition. Elsevier. pp. 1733–1734. ISBN 978-1-4557-7566-8.