Diphyllobothriasis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2], Furqan M M. M.B.B.S[3]

Overview

Medical therapy is the primary modality of treatment for diphyllobothriasis. Drugs used for diphyllobothriasis include either praziquantel or niclosamide.

Medical Therapy

The medications used in the treatment of diphyllobothriasis are:

• Praziquantel
• Niclosamide

Antimicrobial Regimen

The dose for empiric treatment of diphyllobothriasis is as follows:

• Diphyllobothriasis
  • 1.1 Adult
    • Preferred regimen (1): Praziquantel 5-10 mg/kg orally in a single-dose therapy.
    • Alternative regimen (1): Niclosamide 2 gm single dose orally for adults.
  • 1.2 Children
    • Preferred regimen (1): Praziquantel 5-10 mg/kg orally in a single-dose therapy.
    • Alternative regimen (1): Niclosamide 50 mg/kg (max 2 gm) orally once.

Mechanism of action

1. Praziquantel
   • Oral praziquantel is available for human use in the United States. Praziquantel increases the permeability of the cell membrane towards calcium ions. This induces contraction of the parasites, resulting in paralysis in the contracted state.
2. Niclosamide
   • Niclosamide inhibits the oxidative phosphorylation and anaerobic metabolism in the parasites.