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.

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