Comparison of ivermectin and thiabendazole in the treatment of uncomplicated human Strongyloides stercoralis infection

Abstract

Ivermectin is the drug of choice in the treatment of onchocerciasis, and has been proven to be highly effective against Strongyloides stercoralis. This study compares ivermectin's efficacy and safety with that of thiabendazole, an established drug of choice for strongyloidiasis, in 252 confirmed cases of uncomplicated human intestinal strongyloidiasis. Subjects were administered orally with ivermectin (200 mg/kg) in a single dose or thiabendazole, 25 mg/kg, twice daily (50mg/kg/day) for 3 consecutive days. Stools were parasitologically examined 7, 21 and 30 days after treatment. Only 18 of 113 and 22 of 103 ivermectin- and thiabendazole-treated subjects, respectively, had stools positive for larvae 30 days post-treatment. This indicates parasitological cure rates of 84.07% and 78.64% for ivermectin and thiabendazole, respectively. Ivermectin was not significantly more effective than thiabendazole (P < 0.05). There was considerable reduction in parasite output in parasitologically uncured subjects with mean of 81% in ivermectin-treated and 75% in thiabendazole-treated groups, respectively. Clinical adverse reactions were mild and transient in subjects treated with ivermectin, while they varied from mild to severe in those treated with thiabendazole. Single-dose ivermectin provides efficacy comparable with standard, multiple-dose thiabendazole, with a much reduced incidence of adverse effects and consequently better patient compliance.


Key words: Ivermectin, thiabendazole, Strongyloides stercoralis, strongyloidiasis.


African Journal of Biotechnology Vol.2(11) 2003: 465-469