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=== Treatment for asymptomatic, abortive and mild patients: ===
=== Treatment for asymptomatic, abortive and mild patients: ===
**Administration of [[Anthelmintic|anthelmintics]]
*Administration of [[Anthelmintic|anthelmintics]]
**Administration of [[glucocorticoids]] if needed.
*Administration of [[glucocorticoids]] if needed.


=== Treatment for pronounced and severe patients: ===
=== Treatment for pronounced and severe patients: ===
**[[Hospitalization]]
*Hospitalization
***Compulsory for severe cases
**Compulsory for severe cases
**Administration of [[glucocorticoids]], [[Anthelmintic|anthelmintics]] and [[analgesics]].
*Administration of [[glucocorticoids]], [[Anthelmintic|anthelmintics]] and [[analgesics]].
**Administration of fluids and [[Electrolyte|electrolytes]]<ref name="pmid19136437">{{cite journal| author=Gottstein B, Pozio E, Nöckler K| title=Epidemiology, diagnosis, treatment, and control of trichinellosis. | journal=Clin Microbiol Rev | year= 2009 | volume= 22 | issue= 1 | pages= 127-45, Table of Contents | pmid=19136437 | doi=10.1128/CMR.00026-08 | pmc=PMC2620635 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19136437  }} </ref>
*Administration of fluids and electrolytes <ref name="pmid19136437">{{cite journal| author=Gottstein B, Pozio E, Nöckler K| title=Epidemiology, diagnosis, treatment, and control of trichinellosis. | journal=Clin Microbiol Rev | year= 2009 | volume= 22 | issue= 1 | pages= 127-45, Table of Contents | pmid=19136437 | doi=10.1128/CMR.00026-08 | pmc=PMC2620635 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19136437  }} </ref>


{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
== Antihelmintic Regimen<ref name="d">Trichinellosis. CDC. http://www.cdc.gov/parasites/trichinellosis/health_professionals/index.html#tx. Accessed on January 26, 2016</ref> ==
|+ '''Trichinosis Anthelmintics Treatment'''
::'''Trichinosis in adult and children ≥2yrs of age'''
! style="width: 180px;background: #4479BA" |{{fontcolor|#FFF| Drug}}
:::* Preferred regimen (1): [[Albendazole]] 400 mg PO bid for 8 to 14 days {{or}} [[Mebendazole]] 200-400 mg PO tid for 3 days, then 400-500 mg PO tid for 10 days
! style="width: 120px;background: #4479BA" |{{fontcolor|#FFF| Adult and Pediatric Dose}}
:::* Note:
|-
:::**[[Albendazole]]:
| style="width: 120px;font-weight: bold;background: #DCDCDC" | Albendazole
:::***''Pregnancy'': Albendazole is [[Pregnancy category (pharmaceutical)|pregnancy category C]].
| style="background: #F5F5F5; text-align:center" | 400 mg twice a day by mouth for 8 to 14 days
:::***''Lactation:'' It is not known whether albendazole is excreted in human milk.
|-
:::***''Pedriatic patients'': The safety of albendazole in children less than 6 years old is not certain. Studies of the use of albendazole in children as young as one year old suggest that its use is safe.
| style="width: 120px;font-weight: bold;background: #DCDCDC" | Mebendazole
:::**[[Mebendazole]]:
| style="background: #F5F5F5; text-align:center" | 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
:::***Pregnancy: Mebendazole is in pregnancy category C.
|-
:::***Lactation: It is not known whether mebendazole is excreted in breast milk. The WHO classifies mebendazole as compatible with breastfeeding and allows the use of mebendazole in lactating women.
|}
:::***Pedriatic patients: The safety of mebendazole in children has not been established.  
 
*Prompt treatment with [[Antiparasitic|antiparasitic drugs]] can help [[Prevention|prevent]] the progression of trichinellosis by killing the adult worms and so [[Prevention (medical)|preventing]] further release of larvae.  
*Once the larvae have become established in [[Muscle cells|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|pregnant women]] or [[children]] under the age of 2 years.  
*In addition to [[Antiparasitic|antiparasitic medication]], treatment with [[glucocorticoids]] such as [[prednisone]] may be used to relieve [[muscle pain]] associated with larval migration.<ref name="d">Trichinellosis. CDC. http://www.cdc.gov/parasites/trichinellosis/health_professionals/index.html#tx. Accessed on January 26, 2016</ref>


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Conditions diagnosed by stool test]]
 
[[Category:Infectious disease]]
[[Category:Needs overview]]


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{{WH}}
{{WS}}
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Latest revision as of 19:01, 18 September 2017

Trichinosis Microchapters

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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.[1]

Medical Therapy

Treatment for asymptomatic, abortive and mild patients:

Treatment for pronounced and severe patients:

Antihelmintic Regimen[1]

Trichinosis in adult and children ≥2yrs of age
  • Preferred regimen (1): Albendazole 400 mg PO bid for 8 to 14 days OR Mebendazole 200-400 mg PO tid for 3 days, then 400-500 mg PO tid for 10 days
  • Note:
    • Albendazole:
      • Pregnancy: Albendazole is pregnancy category C.
      • Lactation: It is not known whether albendazole is excreted in human milk.
      • Pedriatic patients: The safety of albendazole in children less than 6 years old is not certain. Studies of the use of albendazole in children as young as one year old suggest that its use is safe.
    • Mebendazole:
      • Pregnancy: Mebendazole is in pregnancy category C.
      • Lactation: It is not known whether mebendazole is excreted in breast milk. The WHO classifies mebendazole as compatible with breastfeeding and allows the use of mebendazole in lactating women.
      • Pedriatic patients: The safety of mebendazole in children has not been established.

References

  1. ↑ 1.0 1.1 Trichinellosis. CDC. http://www.cdc.gov/parasites/trichinellosis/health_professionals/index.html#tx. Accessed on January 26, 2016
  2. ↑ 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.


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