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.
Lymphatic Filariasis
- 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 |
Onchocerciasis
- 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 |
Loa Loa Filariasis
- 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.
Antimicrobial Regimen
- Filariasis
-
- Preferred regimen: Diethylcarbamazine 6 mg/day PO qd for 12 days (single dose if patient will continue to live in endemic area or is younger than 9 years old) ± Albendazole 400 mg PO qd
- Alternative regimen: Doxycycline 200 mg/day for 4 weeks ± Ivermectin 150 μg/kg single dose (do not administer Ivermectin if there's a risk of serious adverse effects in areas where Loa loa is coendemic)
- Note: Do not administer Diethylcarbamazine where onchocerciasis is endemic due to the risk of causing severe local inflammation in patients with ocular microfilariae.
- Preferred regimen (1): Doxycycline 150 μg/kg single dose
- Preferred regimen (2): (Doxycycline 100 mg PO qd for 6 weeks OR 200 mg PO qd for 4 weeks) THEN Ivermectin after 4-6 months 150 μg/kg single dose
- Preferred regimen (3): Doxycycline 200 mg PO qd for 6 weeks THEN Ivermectin after 4-6 months 150 μg/kg single dose
References
- ↑ http://www.cdc.gov/parasites/lymphaticfilariasis/health_professionals/dxtx.html
- ↑ http://www.cdc.gov/parasites/onchocerciasis/health_professionals/index.html#dx
- ↑ http://www.cdc.gov/parasites/loiasis/health_professionals/index.html#tx
- ↑ 4.0 4.1 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.
- ↑ 5.0 5.1 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.