Ancylostomiasis medical therapy: Difference between revisions

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{{Ancylostomiasis}}
{{Ancylostomiasis}}
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{{CMG}} {{AE}} {{Kalpana Giri}}


==Overview==
==Overview==
[[Anti-helminthic]] [[therapies]] are recommended among [[patients]] with [[ancylostomiasis]]. [[Efficacy]] of [[treatment]] varies according to the [[severity]] of [[infection]], [[geographical]] [[distribution]], and [[age groups]]. [[Multiple blood transfusion]], [[iron supplements]] are also be given in severe cases.


==Treatment==
==Medical Therapy==
The drug of choice for the treatment of hookworm disease is [[mebendazole]] which
 
is effective against both species, and in addition, will remove the intestinal
[[Anti-helminthic]] [[therapies]] are recommended among [[patients]] with [[ancylostomiasis]]. [[Efficacy]] of [[treatment]] varies according to the [[severity]] of [[infection]], [[geographical]] [[distribution]], and [[age groups]].<ref name="pmid27929101">{{cite journal| author=Loukas A, Hotez PJ, Diemert D, Yazdanbakhsh M, McCarthy JS, Correa-Oliveira R | display-authors=etal| title=Hookworm infection. | journal=Nat Rev Dis Primers | year= 2016 | volume= 2 | issue=  | pages= 16088 | pmid=27929101 | doi=10.1038/nrdp.2016.88 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27929101  }} </ref>
worm Ascaris also, if present. The drug is very efficient, requiring only a
*'''Adult'''
single dose and is inexpensive, the perfect drug. However, treatment requires
**'''For stable uncomplicated cases'''
more than giving the anthelmintic, the patient should also receive dietary
***Preferred regimen: [[albendazole]] 400 mg PO single dose. If failed to respond it is recommended to administer albendazole 400 mg PO q24 h for 3 days or 800 mg PO as a single dose<ref name="pmid31622567">{{cite journal| author=Ronquillo AC, Puelles LB, Espinoza LP, Sánchez VA, Luis Pinto Valdivia J| title=Ancylostoma duodenale as a cause of upper gastrointestinal bleeding: a case report. | journal=Braz J Infect Dis | year= 2019 | volume= 23 | issue= 6 | pages= 471-473 | pmid=31622567 | doi=10.1016/j.bjid.2019.09.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31622567  }} </ref>
supplements to improve their general level of health, in particular iron
***Alternative regimen: [[mebendazole]] 100 mg PO q12h for 3 days.<ref name="pmid27929101">{{cite journal| author=Loukas A, Hotez PJ, Diemert D, Yazdanbakhsh M, McCarthy JS, Correa-Oliveira R | display-authors=etal| title=Hookworm infection. | journal=Nat Rev Dis Primers | year= 2016 | volume= 2 | issue=  | pages= 16088 | pmid=27929101 | doi=10.1038/nrdp.2016.88 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27929101  }} </ref>
supplementation is very important. Iron is an important constituent of a
***Alternative regimen: [[pyrantel pamoate]] 11mg/kg PO q24h for 3 days (maximum, 1gm per dose)
multitude of enzyme systems involved in energy metabolism, DNA synthesis and
**'''For unstable complicated cases'''
drug detoxification.
***[[Albendazole]] 400 mg PO q24 h for 3 days<ref name="pmid31622567">{{cite journal| author=Ronquillo AC, Puelles LB, Espinoza LP, Sánchez VA, Luis Pinto Valdivia J| title=Ancylostoma duodenale as a cause of upper gastrointestinal bleeding: a case report. | journal=Braz J Infect Dis | year= 2019 | volume= 23 | issue= 6 | pages= 471-473 | pmid=31622567 | doi=10.1016/j.bjid.2019.09.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31622567  }} </ref>
***[[Mebendazole]] 100 mg PO q24 h for 5 days
***Multiple  blood transfusion
***Iron supplements
 
*'''Pediatric'''
**'''Children <2 years of age'''
***Currently, for the [[treatment]] of young [[infants]], no guidelines are [[available]]. But current [[knowledge]] shows that the [[side effects]] linked to [[benzimidazole]] drugs in young children are likely to be the same as in older [[children]] and [[adults]]. Therefore, for the [[potential]] [[benefit]] of [[physical]] and [[cognitive development]], the [[treatment]] of [[young infants]] could be [[justified]].<ref name="pmid12745139">{{cite journal| author=Montresor A, Awasthi S, Crompton DW| title=Use of benzimidazoles in children younger than 24 months for the treatment of soil-transmitted helminthiasis. | journal=Acta Trop | year= 2003 | volume= 86 | issue= 2-3 | pages= 223-32 | pmid=12745139 | doi=10.1016/s0001-706x(03)00042-1 | pmc=5633076 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12745139  }} </ref>
***Preferred regimen: [[albendazole]] 200 mg PO single dose.<ref name="pmid20228435">{{cite journal| author=Bhatia V, Das MK, Kumar P, Arora NK| title=Infantile hookworm disease. | journal=Indian Pediatr | year= 2010 | volume= 47 | issue= 2 | pages= 190-2 | pmid=20228435 | doi=10.1007/s13312-010-0033-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20228435  }} </ref>
***Alternative regimen: [[mebendazole]] 100 mg PO q12h for 3 days.<ref name="pmid33563313">{{cite journal| author=Umbrello G, Pinzani R, Bandera A, Formenti F, Zavarise G, Arghittu M | display-authors=etal| title=Hookworm infection in infants: a case report and review of literature. | journal=Ital J Pediatr | year= 2021 | volume= 47 | issue= 1 | pages= 26 | pmid=33563313 | doi=10.1186/s13052-021-00981-1 | pmc=7871578 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33563313  }} </ref>


An infection of ''N. americanus'' parasites can be treated by using [[Imidazole|benzimidazoles]], [[albendazole]], and [[mebendazole]]. A blood transfusion may be necessary in severe cases of anemia. Light infections are usually left untreated in areas where reinfection is common. Iron supplements and a diet high in protein will speed the recovery process.<ref>"hookworm disease." Encyclopædia Britannica. 2009. Encyclopædia Britannica Online. 06 Dec. 2009 <http://www.britannica.com/EBchecked/topic/271350/hookworm-disease>.</ref>  In a case study involving 56-60 men with ''[[Trichuris trichiura]]'' and/or ''N. americanus'' infections, both albendazole and mebendazole were 90% effective in curing ''T. trichiura''.  However, albendazole had a 95% cure rate for ''N. americanus'', while mebendazole only had a 21% cure rate.  This suggests albendazole is most effective for treating both ''T. trichiura'' and ''N. americanus''.<ref> Holzer, B. R.; and Frey, F. J. (February 1987). "Differential efficacy of mebendazole and albendazole against Necator americanus but not for Trichuris trichiura infestations". European Journal of Clinical Pharmacology. 32 (6): 635-637. http://www.springerlink.com/content/k000065915k70257/</ref>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 21:29, 3 December 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalpana Giri, MBBS[2]

Overview

Anti-helminthic therapies are recommended among patients with ancylostomiasis. Efficacy of treatment varies according to the severity of infection, geographical distribution, and age groups. Multiple blood transfusion, iron supplements are also be given in severe cases.

Medical Therapy

Anti-helminthic therapies are recommended among patients with ancylostomiasis. Efficacy of treatment varies according to the severity of infection, geographical distribution, and age groups.[1]

  • Adult
    • For stable uncomplicated cases
      • Preferred regimen: albendazole 400 mg PO single dose. If failed to respond it is recommended to administer albendazole 400 mg PO q24 h for 3 days or 800 mg PO as a single dose[2]
      • Alternative regimen: mebendazole 100 mg PO q12h for 3 days.[1]
      • Alternative regimen: pyrantel pamoate 11mg/kg PO q24h for 3 days (maximum, 1gm per dose)
    • For unstable complicated cases

References

  1. 1.0 1.1 Loukas A, Hotez PJ, Diemert D, Yazdanbakhsh M, McCarthy JS, Correa-Oliveira R; et al. (2016). "Hookworm infection". Nat Rev Dis Primers. 2: 16088. doi:10.1038/nrdp.2016.88. PMID 27929101.
  2. 2.0 2.1 Ronquillo AC, Puelles LB, Espinoza LP, Sánchez VA, Luis Pinto Valdivia J (2019). "Ancylostoma duodenale as a cause of upper gastrointestinal bleeding: a case report". Braz J Infect Dis. 23 (6): 471–473. doi:10.1016/j.bjid.2019.09.002. PMID 31622567.
  3. Montresor A, Awasthi S, Crompton DW (2003). "Use of benzimidazoles in children younger than 24 months for the treatment of soil-transmitted helminthiasis". Acta Trop. 86 (2–3): 223–32. doi:10.1016/s0001-706x(03)00042-1. PMC 5633076. PMID 12745139.
  4. Bhatia V, Das MK, Kumar P, Arora NK (2010). "Infantile hookworm disease". Indian Pediatr. 47 (2): 190–2. doi:10.1007/s13312-010-0033-2. PMID 20228435.
  5. Umbrello G, Pinzani R, Bandera A, Formenti F, Zavarise G, Arghittu M; et al. (2021). "Hookworm infection in infants: a case report and review of literature". Ital J Pediatr. 47 (1): 26. doi:10.1186/s13052-021-00981-1. PMC 7871578 Check |pmc= value (help). PMID 33563313 Check |pmid= value (help).

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