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*''Strongyloides stercoralis'' | *''Strongyloides stercoralis'' | ||
:* Preferred regimen (1): [[Ivermectin]] 200 μg/kg/day PO q24h for 2 days | :* Preferred regimen (1): [[Ivermectin]] 200 μg/kg/day PO q24h for 2 days | ||
:* Note: For immunocompromised patients several treatment courses at 2-week intervals is recommended. | :** Note: For immunocompromised patients several treatment courses at 2-week intervals is recommended. | ||
:* Alternative regimen (1): [[Thiabendazole]] 1.5 g PO q24h for 2 consecutive days. | :* Alternative regimen (1): [[Thiabendazole]] 1.5 g PO q24h for 2 consecutive days. | ||
:* Note: The maximum dosage is 3 g/d every 2 days (this dosage is likely to be toxic and needs to be reduced) | :** Note: The maximum dosage is 3 g/d every 2 days (this dosage is likely to be toxic and needs to be reduced) | ||
:* Note: Cure rates as high as 87% to 94%, but the drug may not be effective in the disease that is disseminated beyond the gastrointestinal tract. | :** Note: Cure rates are as high as 87% to 94%, but the drug may not be effective in the disease that is disseminated beyond the gastrointestinal tract. | ||
:* Note: Many patients have gastrointestinal adverse effects, it is used rarely in the U.S. because of adverse effects | :** Note: Many patients have gastrointestinal adverse effects, it is used rarely in the U.S. because of adverse effects | ||
:* Alternative regimen (2): [[Albendazole]] 400 mg PO bid for 3 days | :* Alternative regimen (2): [[Albendazole]] 400 mg PO bid for 3 days | ||
Revision as of 15:12, 9 August 2017
Medical therapy
Uncomplicated strongylidiasis
- Strongyloides stercoralis
- Preferred regimen (1): Ivermectin 200 μg/kg/day PO q24h for 2 days
- Note: For immunocompromised patients several treatment courses at 2-week intervals is recommended.
- Alternative regimen (1): Thiabendazole 1.5 g PO q24h for 2 consecutive days.
- Note: The maximum dosage is 3 g/d every 2 days (this dosage is likely to be toxic and needs to be reduced)
- Note: Cure rates are as high as 87% to 94%, but the drug may not be effective in the disease that is disseminated beyond the gastrointestinal tract.
- Note: Many patients have gastrointestinal adverse effects, it is used rarely in the U.S. because of adverse effects
- Alternative regimen (2): Albendazole 400 mg PO bid for 3 days
- Preferred regimen (1): Ivermectin 200 μg/kg/day PO q24h for 2 days
Complicated strongyloidiasis (Disseminated or hyper-infection syndrome)
- Preferred regimen (1): Ivermectin 200 μg/kg/d PO q24h orally for at least 7 to 10 days (until larvae are no longer detected in stool, sputum, or urine)
- Note: For hyper-infection and disseminated disease, adding albendazole (400 mg PO bid for 7 days) to ivermectin may be warranted.