Trichinosis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Danitza Lukac

Overview

The mainstay of therapy for trichinosis are anthelmintics such as albendazole or mebendazole.

Medical therapy

• Treatment for asymptomatic, abortive and mild patients:
  • Administration of anthelmintics
  • Administration of steroids if needed.
• Treatment for pronounced and severe patients:
  • Hospitalization
    • Compulsory for severe cases
  • Administration of steroids, anthelmintics and analgesics.
  • Administration of fluids and electrolytes

Trichinosis Anthelmintics Treatment

Drug	Adult and Pediatric Dose
Albendazole	400 mg twice a day by mouth for 8 to 14 days
Mebendazole	200 to 400 mg three times a day by mouth for 3 days, then 400 to 500 mg three times a day by mouth for 10 days

• Prompt treatment with antiparasitic drugs can help prevent the progression of trichinellosis by killing the adult worms and so preventing further release of larvae.
• Once the larvae have become established in skeletal muscle cells, usually by 3 to 4 weeks post infection, treatment may not completely eliminate the infection and associated symptoms.
• Treatment with either mebendazole or albendazole is recommended.
• If treatment is not initiated within the first several days of infection, more prolonged or repeated courses of treatment may be necessary.
• Both drugs are considered relatively safe but have been associated with side effects including bone marrow suppression.
• Patients on longer courses of therapy should be monitored by serial complete blood counts to detect any adverse effects promptly and discontinue treatment.
• Albendazole and mebendazole are not approved for use in pregnant women or children under the age of 2 years.
• In addition to antiparasitic medication, treatment with steroids such as prednisone may be used to relieve muscle pain associated with larval migration.