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AI-Generated response:

What is the most effective treatment for hookworm?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

The most effective treatment for hookworm is albendazole 400 mg orally as a single dose.[1-2]

Mebendazole and pyrantel pamoate are less effective alternatives.[1-2]

  • Albendazole is administered as a single oral dose of 400 mg for both children and adults.[1]

  • Mebendazole can be given as 100 mg orally twice daily for 3 days or as a single 500 mg dose.[1][3-4]

  • Pyrantel pamoate is dosed at 11 mg/kg (maximum 1 g/dose) orally once daily for 3 days.[1]

  • Side effects of albendazole include gastrointestinal symptoms such as abdominal pain, nausea, and dizziness. It is contraindicated in pregnant women due to potential harm to the fetus.[1]

  • Mebendazole's side effects include transient abdominal pain and diarrhea; it is also contraindicated during pregnancy.[5]

Additional info

Albendazole is considered the drug of choice for treating hookworm infections due to its efficacy and ease of administration as a single dose. This makes it particularly useful in mass treatment programs in endemic areas. Mebendazole, while effective, requires a longer course of treatment, which can complicate adherence. Pyrantel pamoate is another option but is generally considered less effective than albendazole. It is important for physicians to consider the potential side effects and contraindications of these medications, especially in populations such as pregnant women, where albendazole and mebendazole are contraindicated. Iron supplementation should be considered in patients with significant anemia resulting from hookworm infection.[2]

References

Reference 1

1.

Elsevier ClinicalKey Clinical Overview

Treatment Anthelmintics Albendazole (most effective agent) Albendazole Oral tablet; Children and Adolescents: 400 mg PO as a single dose. Albendazole Oral tablet; Adults: 400 mg PO as a single dose. Mebendazole Mebendazole Chewable tablet; Children and Adolescents 2 to 17 years: 100 mg PO twice daily for 3 days. If not cured 3 weeks after treatment, a second course of therapy is recommended. Mebendazole Chewable tablet; Adults: 100 mg PO twice daily for 3 days. If not cured 3 weeks after treatment, a second course of therapy is recommended. Pyrantel pamoate Pyrantel pamoate Oral suspension; Children and Adolescents: 11 mg/kg base/dose (Max: 1 g/dose) PO once daily for 3 days. Pyrantel pamoate Chewable tablet; Adults: 11 mg/kg base/dose (Max: 1 g/dose) PO once daily for 3 days.

Reference 2

2.

Diemert, David J. (2024). In Goldman-Cecil Medicine (pp. 2169). DOI: 10.1016/B978-0-323-93038-3.00327-0

For intestinal hookworm infection, three daily oral doses of albendazole 400mg is the recommended treatment (seeTable 327-1). Tribendimidine, which is not FDA approved and is not available or approved in most countries, has a similar efficacy profile as albendazole as a single oral dose of 400mg, alone or in combination with other anthelminthics, such as single-dose ivermectin or oxantel pamoate.Less effective alternatives include mebendazole, pyrantel pamoate, and single-dose albendazole. Iron supplementation is recommended in patients with significant or symptomatic anemia.For cutaneous larva migrans, although the disease is self-limited and will resolve spontaneously within weeks to a few months, treatment with one to two daily doses of ivermectin (200µg/kg) leads to faster resolution of symptoms and skin manifestations. Albendazole is an alternative treatment of cutaneous larva migrans.

Reference 3

3.

Elsevier ClinicalKey Drug Monograph

Content last updated: January 4, 2024.

Indications And Dosage **For the treatment of hookworm infection** Oral dosage (single-dose regimen) † Adults: 500 mg PO as a single dose. Children and Adolescents: 500 mg PO as a single dose. Oral dosage (3-day regimen) Adults: 100 mg PO twice daily for 3 days. If not cured 3 weeks after treatment, a second course of therapy is recommended. Children and Adolescents 2 to 17 years: 100 mg PO twice daily for 3 days. If not cured 3 weeks after treatment, a second course of therapy is recommended. Children 1 year †: 100 mg PO twice daily for 3 days. If not cured 3 weeks after treatment, a second course of therapy is recommended.

Reference 4

4.

Food and Drug Administration (DailyMed).

Publish date: August 1, 2021.

Clinical Studies 14 CLINICAL STUDIES Efficacy rates derived from various studies are shown in Table 4 below: Table 4: Mean Cure Rates and Egg Reductions from Clinical Studies Pinworm (enterobiasis) Whipworm (trichuriasis) Roundworm (ascariasis) Hookworm Cure rates mean 95% 68% 98% 96% Egg reduction mean - 93% 99% 99%

Reference 5

5.

Budge, Philip J., Pearson, Richard D. (2024). In Goldman-Cecil Medicine (pp. 2111). DOI: 10.1016/B978-0-323-93038-3.00315-4

Mebendazole is only slightly soluble in water and is relatively poorly absorbed from the gastrointestinal tract. This characteristic is advantageous for the treatment of intestinal parasites but limits its effectiveness against tissue-dwelling helminths. Absorbed drug is metabolized in the liver and excreted in urine. Mebendazole selectively binds to helminthic tubulin, blocks its assembly into microtubules, and inhibits glucose uptake. This leads to depletion of glycogen stores and ultimately death of the parasite. Mebendazole is relatively well tolerated in the doses used to treat intestinal helminths. Transient abdominal pain and diarrhea occur in a small number of recipients. Mebendazole is contraindicated during pregnancy. Mebendazole (100mg orally twice daily for 3 days) has a similar spectrum of activity as albendazole againstA. lumbricoides, hookworms, andT. trichiura. In this regimen, it is more effective than a single dose of albendazole and is considered the treatment of choice for heavyT. trichiurainfections. A single 500-mg dose of mebendazole has been used in mass treatment programs. Mebendazole is effective in treating pinworms when given at 100mg orally in one dose followed by a second dose after 2 weeks. It is an alternative to albendazole for the treatment of trichinosis. Mebendazole is poorly absorbed and ineffective againstS. stercoralis.

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