Filariasis medical therapy: Difference between revisions

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The recommended treatment for patients outside the United States is albendazole (a broad spectrum anthelmintic) combined with ivermectin.^[1] A combination of diethylcarbamazine (DEC) and albendazole is also effective. All of these treatments are microfilaricides; they have no effect on the adult worms.

Medical Therapy

Different drugs are recommended for the treatment of filariasis depending on the specific causal agent.

Lymphatic Filariasis

Medicines to treat lymphatic filariasis are most effective when used soon after infection, but they do have some toxic side effects. In addition, the disease is difficult to detect early. Therefore, improved treatments and laboratory tests are needed. Once Filaria is attacked, the patients are likely to get fever once in a year or two with shivering. They are also administered Florocid injections.

Antibiotics

In 2003 it was suggested that the common antibiotic doxycycline might be effective in treating elephantiasis.^[2] The parasites responsible for filariasis have a population of symbiotic bacteria, Wolbachia, that live inside the worm. When the symbiotic bacteria are killed by the antibiotic, the worms themselves also die. Clinical trials in June 2005 by the Liverpool School of Tropical Medicine reported that an 8 week course almost completely eliminated microfilariaemia.^[3]^[4]

Diethylcarbamazine Citrate (Hetrazan)

The good drugs of choice for killing adult filarial worm are Albendazole (broad spectrum anti-helminthic) and Ivermectin. A combination of DEC & Albendazole or DEC & Ivermectin is found more effective

Onchocerciasis

Shown below is a table summarizing the preferred and alternative empiric treatment for Onchocerciasis^[5]

Characteristics of the Patient	Possible Pathogens	Preferred Treatment	Duration of Treatment	Alternative Treatment
Adult	Onchocerca volvulus (microfilariae)	Ivermectin 150 mcg/kg orally in one dose	Every 6 months	Doxycycline 200 mg orally daily for 6 weeks
Pediatric	Onchocerca volvulus (microfilariae)	Ivermectin 150 mcg/kg orally in one dose	Every 6 months	Doxycycline 200 mg orally daily for 6 weeks

References

↑ U.S. Centers for Disease Control, Lymphatic Filariasis Treatment, retrieved 2008-07-17
↑ Hoerauf A, Mand S, Fischer K, Kruppa T, Marfo-Debrekyei Y, Debrah AY, Pfarr KM, Adjei O, Buttner DW (2003). "Doxycycline as a novel strategy against bancroftian filariasis-depletion of Wolbachia endosymbionts from Wuchereria bancrofti and stop of microfilaria production". Med Microbiol Immunol (Berl). 192 (4): 211–6. PMID 12684759.
↑ Taylor MJ, Makunde WH, McGarry HF, Turner JD, Mand S, Hoerauf A (2005). "Macrofilaricidal activity after doxycycline treatment of Wuchereria bancrofti: a double-blind, randomised placebo-controlled trial". Lancet. 365 (9477): 2116–21. PMID 15964448.
↑ Outland, Katrina (2005 Volume 13). "New Treatment for Elephantitis: Antibiotics". The Journal of Young Investigators. Check date values in: |date= (help)
↑ http://www.cdc.gov/parasites/onchocerciasis/health_professionals/index.html#dx

Template:WikiDoc Sources

[CDC-1] U.S. Centers for Disease Control, Lymphatic Filariasis Treatment, retrieved 2008-07-17

[MedMicrobiolImmunol2003-Hoerauf-2] Hoerauf A, Mand S, Fischer K, Kruppa T, Marfo-Debrekyei Y, Debrah AY, Pfarr KM, Adjei O, Buttner DW (2003). "Doxycycline as a novel strategy against bancroftian filariasis-depletion of Wolbachia endosymbionts from Wuchereria bancrofti and stop of microfilaria production". Med Microbiol Immunol (Berl). 192 (4): 211–6. PMID 12684759.

[Lancet2005-Taylor-3] Taylor MJ, Makunde WH, McGarry HF, Turner JD, Mand S, Hoerauf A (2005). "Macrofilaricidal activity after doxycycline treatment of Wuchereria bancrofti: a double-blind, randomised placebo-controlled trial". Lancet. 365 (9477): 2116–21. PMID 15964448.

[JYI2005-Outland-4] Outland, Katrina (2005 Volume 13). "New Treatment for Elephantitis: Antibiotics". The Journal of Young Investigators. Check date values in: |date= (help)

[5] ttp://www.cdc.gov/parasites/onchocerciasis/health_professionals/index.html#dx

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@@ Line 9: / Line 9: @@
 Different drugs are recommended for the treatment of filariasis depending on the specific causal agent.
-===Lymphatic filariasis===
+===Lymphatic Filariasis===
 Medicines to treat lymphatic filariasis are most effective when used soon after infection, but they do have some toxic side effects. In addition, the disease is difficult to detect early. Therefore, improved treatments and laboratory tests are needed.
 Once Filaria is attacked, the patients are likely to get fever once in a year or two with shivering. They are also administered Florocid injections.
 ====Antibiotics====
@@ Line 21: / Line 19: @@
 ====Diethylcarbamazine Citrate (Hetrazan)====
 The good drugs of choice for killing adult filarial worm are Albendazole (broad spectrum anti-helminthic) and Ivermectin. A combination of DEC & Albendazole or DEC & Ivermectin is found more effective
+===Onchocerciasis===
+;Shown below is a table summarizing the preferred and alternative empiric treatment for Onchocerciasis<ref>http://www.cdc.gov/parasites/onchocerciasis/health_professionals/index.html#dx</ref>
+{| class="wikitable" border="1" style="background:FloralWhite"
+|- align="center"
+|'''Characteristics of the Patient'''
+|'''Possible Pathogens'''
+|'''Preferred Treatment'''
+|'''Duration of Treatment'''
+|'''Alternative Treatment'''
+|- align="center"
+|'''Adult'''
+| Onchocerca volvulus (microfilariae)
+| '''Ivermectin'''
+mcg/kg orally in one dose
+| Every 6 months
+|Doxycycline
+mg orally daily for 6 weeks
+|- align="center"
+|'''Pediatric'''
+|Onchocerca volvulus (microfilariae)
+| '''Ivermectin'''
+mcg/kg orally in one dose
+| Every 6 months
+| Doxycycline
+mg orally daily for 6 weeks
+|}
 ==References==