Filariasis medical therapy

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

Medical Therapy

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

Shown below is a table summarizing the preferred and alternative empiric treatment for Lymphatic filariasis.^[1]

Characteristics of the Patient	Possible Pathogens	Preferred Treatment	Duration of Treatment
Adults and children > 18 months of age	Wuchereria bancrofti OR Brugia malayi	Diethylcarbamazine Citrate (6mg/kg/day)	Either a 1 day or 12 day treatment course

Shown below is a table summarizing the preferred and alternative empiric treatment for Onchocerciasis^[2]

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

Shown below is a table summarizing the preferred treatment for Loa loa filariasis^[3]

Characteristics of the Patient	Possible Pathogens	Preferred Treatment	Duration of Treatment
Symptomatic loiasis with MF/mL <8,000	Loa loa	Diethylcarbamazine (DEC) 8–10 mg/kg orally in 3 divided doses daily	For 21 days
Symptomatic loiasis, with MF/mL <8,000 and failed 2 rounds DEC OR Symptomatic loiasis, with MF/ml ≥8,000 to reduce level to <8,000 prior to treatment with DEC	Loa loa	Albendazole 200 mg orally twice daily	For 21 days
Symptomatic loiasis, with MF/mL ≥8,000	Apheresis* followed by DEC	N/A	N/A

(*)Apharesis should be performed at an institution with experience in using this therapeutic modality for loiasis.