infectious diseases
Strongyloidiasis
Treatment of Strongyloidiasis
Ivermectin Alternatively,albendazole ( Treatment reference ). Ivermectin200 mcg/kg orally once a day for 2 days is used for uncomplicated infection and is generally well-tolerated. Before treatment withivermectin, patients should be assessed for coinfection withLoa loaif they have lived in or traveled to areas of central Africa whereLoa loais endemic becauseivermectincan cause severe reactions in patients with loiasis and high microfilarial levels.Albendazole400 mg orally twice a day for 7 days is an alternative for treatment of strongyloidiasis. Immunocompromised patients require prolonged therapy until sputum and/or stool are negative for 2 weeks. Sometimes repeated courses of treatment are needed. In severely ill patients who are unable to take oral drugs, rectal preparations ofivermectinor the veterinary subcutaneous formulation ofivermectinhas been used. Before treating uncomplicated strongyloidiasis withivermectin, assess patients for coinfection withLoa loa. Hyperinfection syndrome and disseminated strongyloidiasis in patients with strongyloidiasis are life-threatening medical emergencies.Ivermectin200 mcg/kg orally once a day is continued until sputum and stool examinations for rhabditiform and filariform larvae are negative for 2 weeks. Broad-spectrum antibiotics are used to treat concurrent polymicrobial bacterial infections associated with larval invasion from the bowel. After treatment of strongyloidiasis, cure should be documented by repeated stool examinations 2 to 4 weeks later. If the stool remains positive, retreatment is indicated. 1.Henriquez-Camacho C, Gotuzzo E, Echevarria J, et al:IvermectinversusalbendazoleorthiabendazoleforStrongyloides stercoralisinfection.Cochrane Database Syst Rev18 (1):CD007745, 2016. doi: 10.1002/14651858.CD007745.pub3 