Filariasis medical therapy: Difference between revisions
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{{Filariasis}} | {{Filariasis}} | ||
{{CMG}} | {{CMG}} | ||
== | ==Overview== | ||
Different drugs are recommended for the treatment of filariasis depending on the specific causal pathogen. | |||
==Medical Therapy== | |||
=== | |||
===Antimicrobial Regimen=== | ===Antimicrobial Regimen=== | ||
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:::* Preferred regimen: [[Diethylcarbamazine]] 6 mg/kd/day PO tid for 12 days (single dose if patient will continue to live in endemic area or is younger than 9 years old) | :::* Preferred regimen: [[Diethylcarbamazine]] 6 mg/kd/day PO tid for 12 days (single dose if patient will continue to live in endemic area or is younger than 9 years old) | ||
::* 2. '''Loa loa filariasis''' | ::* 2. '''Loa loa filariasis''' | ||
:::* Preferred regimen: [[Diethylcarbamazine]] | :::* 2.1 '''Symptomatic loiasis with microfilariae/mL < 8,000''' | ||
::::* Preferred regimen: [[Diethylcarbamazine]] 8–10 mg/kd/day PO tid for 21 days | |||
:::* 2.2 '''Symptomatic loiasis, with microfilariae/mL < 8,000 and failed 2 rounds DEC''' | |||
::::* Preferred regimen: [[Albendazole]] 200 mg PO bid for 21 days | |||
:::* 2.3 '''Symptomatic loiasis, with microfilariae/ml ≥ 8,000 to reduce level to < 8,000 prior to treatment with DEC''' | |||
::::* Preferred regimen: [[Albendazole]] 200 mg PO bid for 21 days | |||
:::* 2.4 '''Symptomatic loiasis, with microfilariae/mL ≥ 8,000''' | |||
::::* Preferred regimen: Apheresis followed by DEC | |||
::::* Note: Apheresis should be performed at an institution with experience in using this therapeutic modality for loiasis. | |||
::* 3. ''' River blindness caused by Onchocerca volvulus''' | ::* 3. ''' River blindness caused by Onchocerca volvulus''' | ||
:::* Preferred regimen: [[Ivermectin]] 150 μg/kg PO single dose, repeated every 6-12 mos until asymptomatic | :::* Preferred regimen: [[Ivermectin]] 150 μg/kg PO single dose, repeated every 6-12 mos until asymptomatic | ||
Revision as of 23:21, 30 July 2015
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Risk calculators and risk factors for Filariasis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Different drugs are recommended for the treatment of filariasis depending on the specific causal pathogen.
Medical Therapy
Antimicrobial Regimen
-
- 1. Lymphatic filariasis caused by Wuchereria bancrofti, Brugia malayi, Brugia timori
- Preferred regimen: Diethylcarbamazine 6 mg/kd/day PO tid for 12 days (single dose if patient will continue to live in endemic area or is younger than 9 years old)
- 2. Loa loa filariasis
- 2.1 Symptomatic loiasis with microfilariae/mL < 8,000
- Preferred regimen: Diethylcarbamazine 8–10 mg/kd/day PO tid for 21 days
- 2.2 Symptomatic loiasis, with microfilariae/mL < 8,000 and failed 2 rounds DEC
- Preferred regimen: Albendazole 200 mg PO bid for 21 days
- 2.3 Symptomatic loiasis, with microfilariae/ml ≥ 8,000 to reduce level to < 8,000 prior to treatment with DEC
- Preferred regimen: Albendazole 200 mg PO bid for 21 days
- 2.4 Symptomatic loiasis, with microfilariae/mL ≥ 8,000
- Preferred regimen: Apheresis followed by DEC
- Note: Apheresis should be performed at an institution with experience in using this therapeutic modality for loiasis.
- 3. River blindness caused by Onchocerca volvulus
- Preferred regimen: Ivermectin 150 μg/kg PO single dose, repeated every 6-12 mos until asymptomatic
- Alternative regimen: Doxycycline 100 mg/day PO for 6 weeks, alone or followed by Ivermectin 150 μg/kg PO single dose
- Note: Do NOT administer Diethylcarbamazine where onchocerciasis is endemic due to increased risk for severe local inflammation in patients with ocular microfilariae.
References
- ↑ "Drugs for Parasitic Infections (Treatment Guidelines from The Medical Letter)".
- ↑ Taylor MJ, Hoerauf A, Bockarie M (2010). "Lymphatic filariasis and onchocerciasis". Lancet. 376 (9747): 1175–85. doi:10.1016/S0140-6736(10)60586-7. PMID 20739055.
- ↑ Knopp S, Steinmann P, Hatz C, Keiser J, Utzinger J (2012). "Nematode infections: filariases". Infect Dis Clin North Am. 26 (2): 359–81. doi:10.1016/j.idc.2012.02.005. PMID 22632644.