TREATMENT OF PARASITIC DISEASES
OF RELEVANCE IN EGYPT
*******************
Data presented is compiled from:
* Medical Letter:” Drugs for Parasitic Infections”
* Encyclopedia Reference of Parasitology: 2nd edition;
Heinz Melhorn Editor; Springer-Verlag
**********************
Abbreviations: d= day; qd= daily (quaque die); qh= each hour every hour; qd= each day, every day; bid= twice daily; tid= three times per day; qid= four times per day (quarter in die); p.c. (post cibum) = after meals.
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AMOEBIASIS
Entamoeba histolytica
ASYMPTOMATIC CASES
Drug of choice
Chemical class: 8-hydroxyquinoline (luminal on trophozoites)
Non propriety name: iodoquinol
Adult dose: 600 mg tid x 20 d;
Pediatric dose: 30-40 mg/kg/d (max.2g) in 3 doses x 20 d
Chemical class: aminoglycoside (modif. of bacterial flora)
Non propriety name: paromomycin (Humatin)
Adult & Pediatric dose: 25-35 mg/kg/d in 3 doses x 7 d
Alternative Drug
Chemical class: dichloroacetamide
Non propriety name: diloxanide furoate (Furamide)
Adult dose: 500 mg tid x 10 d
Pediatric dose: 20 mg/kg/d in 3 doses x 10 d
MILD TO MODERATE INTESTINAL DISEASE
Drug of choice
Chemical class: 5-nitroimidazole
Non propriety name: metronidazole (Flagyl)
Adult dose: 500-750 tid x 10 d
Pediatric dose: 35-50 mg/kg/d in 3 doses x 10 d
Chemical class: 5-nitroimidazole
Non propriety name: tinidazole (Fasigyn)
Adult dose: 2 grams/d x 3 d
Pediatric dose: 50 mg/kg (max.2g) qd x 3 d
SEVERE INTESTINAL DISEASE
HEPATIC ABSCESS
Drug of choice
Chemical class: 5-nitroimidazole
Non propriety name: metronidazole (Flagyl)
Adult dose: 750 mg tid x 10 d;
Pediatric dose: 35-50 mg/kg/d in 3 doses x 10 d
Chemical class: 5-nitroimidazole
Non propriety name: tinidazole (Fasigyn)
Adult dose: 600 mg bid or 800 mg tid x 5 d
Pediatric dose: 50 mg/kg or 60 mg /kg (max. 2g) qd x 5 d
Chemical class: 5-nitroimidazole
Non propriety name: ornidazole (Tiberal)
Adult dose: 2 grams once a day x 3 d
AMOEBIC INFECTIONS OF CNS & EYES
Primary meningoencephalitis (PAM)
Acanthamoeba spp., Naeglaria spp., Balamuthia mandrillas
Drug of choice
Chemical class: polyene antibiotic
Non propriety name: amphoterecin B
1-(15) mg/kg/d x 3 d i.v. followed by 1 mg/ kg/d x 6 d i.v. or longer
+ amphotericin B intrathecally and
miconazole or rifampicin i.v.
Granulomatous amoebic encephalitis (GAE)
Acanthamoeba & B. mandrillaris
treated by total excision of brain tumor and administration of
miconazole
ketoconazole (azoles)
Acanthamoeba meningitis
penicillin
chloramphenicol
flucytosine (pyrimidone analog)
Acanthamoeba chronic progressive ulcerative keratitis
propamidine
miconazole
neosporin (topical) + epithelial debriment
or ciotrimazole, ketoconazole (systemic)
or itraconazole + miconazole (topical) + epithlial debriment
ANCYLOSTOMIASIS
Ancylostoma caninum (Eosinophilic enterocolitis)
Ancylostoma duodenale, Necator americanus
Drug of choice
Chemical class: benzimidazole carbamates
Non propriety name: mebendazole
Adult & Pediatric dose: 100 mg bid x 3d
Non propriety name: albendazole
Adult & Pediatric dose: 400 mg once or 200 mg/d x 3d
Chemical class: tetrahydropyrimidines
Non propriety name: pyrantel pamoate
Adult & Pediatric dose: 11 mg/kg, max 1 gram /d x 3d
Chemical class: Imidazothiazoles
Non propriety name: levamisole
or (quaternary amines)
ASCARIASIS
Ascaris lumbricoides
Drug of choice:
Chemical class:benzimidazole carbamates
Non propriety name: mebendazole
Adult & Pediatric dose: 100 mg bid x 3d or 500 mg once
Non propriety name: albendazole
Adult & Pediatric dose: 400 mg once
Chemical class: tetrahydropyrimidines
Non propriety name: pyrantel pamoate
Adult & Pediatric dose: 11 mg/kg once max 1 gram
Chemical class: piperazine derivatives
Non propriety name: piperazine derivatives [(syn.: diethylenediamine)-
salts: hexahydrate, adipate,citrate,phosphates]
Chemical class: imidazothiazoles
Non propriety name: tetramisole: [mixture of D-(+) dexamisole &
L-(-) levamisole]
BABESIOSIS
Babesia spp.
Drug of choice:
Chemical class: macrolide antibiotic
Non propriety name: clindamycin
Adult dose: 1.2 grams bid IV or 600 mg tid PO x 7 d
Pediatric dose: 20-40 mg/kg/d in tid x 7
plus
Chemical class: chinchona alkaloid
Non propriety name: quinine
Adult dose: 650 mg tid P0 x 7 d
Pediatric dose: 25 mg/kg/d tid x 7 d
BALANTIDIASIS
Balatidium coli
Drug of choice:
Chemical class: tetracycline
Non propriety name: doxycillin
Adult dose: 500 mg qid x10 d
Pediatric dose: 40 mg/kg/d (max.2 grams) qid x 10 d
Chemical class: 5- nitroimidazole
Non propriety name: metronidazole (Flagyl)
Adult dose: 750 mg tid x 5d
Pediatric dose: 35 - 50 mg/kg/d in tid x 5 d
Alternative drug:
Chemical class: 8- hydroxyquinoline
Non propriety name: iodoquinol
Adult dose: 650 mg tid x 20 d
Pediatric dose: 40 mg/kg/d tid x 20 d
BLASTOCYSTOSIS
Blastocystis hominis
Drug of choice:
Chemical class: 5- nitroimidazole
Non propriety name: metronidazole
Adult dose: 750 mg tid x 10 d
Pediatric dose: 35 - 50 mg/kg/d tid x 5 d
Chemical class: 8- hydroxyquinoline
Non propriety name: iodoquinol
Adult dose: 650 mg tid x 20 d
Pediatric dose: 40 mg/kg/d tid x 20 d
CAPILLARIASIS
Capillaria hepatica
Drug of choice:
Chemical class: benzimidazoles
Non propriety name: albendazole, thiabendazole
Adult & Pediatric dose: 400 mg daily x 10 d
Capillaria phillipinensis
Drug of choice:
Chemical class: benzimidazole carbamates
Non propriety name: mebendazole
Adult & Pediatric dose: 200 mg bid x 20 d
Alternative drug: (for 3 rd. stage larvae & adults):
Chemical class: benzimidazoles
Non propriety name: albendazole, thiabendazole
Adult & Pediatric dose: 400 mg daily x 10 d
CRYPTOSPORIDIOSIS
Cryptosporidium spp.
Drug of choice:
Chemical class: aminoglycoside
Non propriety name: paromomycin
Adult dose: 25-35 mg/kg/d in 3 or 4 doses
Pediatric dose: 6 mg/kg/d in 4 doses x 7-10d
CYCLOSPORIASIS
Cyclospora spp.
Drug of choice:
Chemical class:
Non propriety name: trimethoprim-sulfamethoxazole
Adult dose: TMP 160 mg, SMX 800 MG / bid x7d
Pediatric dose: TMP 5 mg/kg, SMX 25 mg/kg / bid x 7d
CYSTICERCOSIS
Cysticercus cellulosae
(See Taeniasis)
ENTEROBIASIS (Syn. Oxyuriasis, pin worm infection)
Enterobius vermicularis
Drug of choice:
Chemical class: tetrahydropyrimidines
Non propriety name: pyrantel pamoate
Adult & Pediatric dose: 11 mg/kg once max 1 g; repeat in 2 weeks
Chemical class: benzimidazole carbamates
Non propriety name: mebendazole
Adult & Pediatric dose: 100 mg once repeat in 2 weeks
Chemical class: benzimidazoles
Non propriety name: albendazole
Adult dose: 400 mg once repeat in 2 weeks
Pediatric dose: 400 mg or 10-14 mg/kg once; repeat in 2 weeks.
FASCIOLIASIS
Fasciola gigantica
Fasciola hepatica
Drug of choice:
Chemical class: bisphenols
Non propriety name: bithionol
Adult & Pediatric dose: 30-50 mg/kg on alternate days 10-15 doses
Chemical class: benzimidazoles
Non propriety name: triclabendazole Fasinex.htm
Adult & Pediatric dose: 10 mg/kg once
GIARDIASIS
Giardia lamblia
Drug of choice:
Chemical class: 5-nitrimidazole
Non propriety name: metronidazole
Adult dose: 250 mg tid x 5d.
Pediatric dose: 15 mg/kg/d in 3 doses x 5d
Chemical class: 5- nitroimidazole
Non propriety name: tinidazole
Adult dose: 2 grams once
Pediatric dose: 50 mg/kg once (max. 2 g)
Treatment should be followed by administration of iodoquinol or paromomycin in doses
as used to treat asymptomatic amoebiasis.
Chemical class: nitrofuran
Non propriety name: furazolidone
Adult dose: 100 mg qid x 7-10d
Pediatric dose: 6 mg/kg/d in 4 doses x 7-10d
Chemical class: aminoglycoside
Non propriety name: paromomycin
Adult dose: 25-35 mg/kg/d in 3 doses x 7d
Pediatric dose: 6 mg/kg/d in 4 doses x 7-10d
HETEROPHYIASIS
Heterophyes heterophyes
Drug of choice:
Chemical class: pyrazinoisoquinolines
Non propriety name: praziquantel
Adult & Pediatric dose: 3 x 25 mg/kg x 1d
Alternative Drug:
Chemical class: salicylanilides
Non propriety name: niclosamide
Adult & Pediatric dose:
Chemical class: bisphenols
Non propriety name: menichlopholan=niclofolan
HYDATIDOSIS
Drug of choice:
Chemical class: benzimidazole carbamates
Non propriety name: albendazole
Adult dose: 400 mg bid x 28d repeated as necessary
Alternative Drug:
Chemical class: pyrazinoisoquinolines
Non propriety name: praziquantel (preoperative or in case of fluid spill)
Adult dose: 50 mg/kg in 3 doses x 15d
HYMENOLEPIASIS
Hymenolepis nana & Hymenolepis diminuta
Drug of choice:
Chemical class: pyrazinoisoquinolines
Non propriety name: praziquantel
Adult & Pediatric dose: 25 mg/kg once
Alternative Drug:
Chemical class: salicylanilides
Non propriety name: niclosamide (Yomesan)
Adult & Pediatric dose: 2 g x1d; 1 g x 6d
ISOSPORIASIS
Isospora belli
Drug of choice:
Chemical class: trimethoprim-sulfamethoxazole
Non propriety name: septazol, sutrim, bacterim
Adult dose: 160 mg TMP/800 mg SMX (1 tablet) bid x 10 d, then bid x 3 wks
Pediatric Dose: 5 mg/kg TMP/25 mg/kg SMX bid x 10d
LEISHMANIASIS
Old World Leishmaniasis
Cutaneous leishmaniasis (=CL)
Leishmania (L) tropica
Leishmania (L) major
Leishmania (L) aethiopica
Visceral leishmaniasis (=VL)
Leishmania (L) donovani
Leishmania (L) infantum
Drug of choice:
Chemical class: pentavalent antimonials
Non propriety name: sodium stibogluconate
Adult dose: 20 mg Sb/kg/d i.v. or i.m. 20-28d (may be repeated or continued , e.g. for some forms of VL)
Non propriety name: meglumine antimonate
Adult dose: 20 mg Sb/kg/d i.v. or i.m. 20-28d (may be repeated or continued , e.g. for some forms of VL)
Alternative Drug:
Chemical class: polyene macrolide antibiotics
Non propriety name: amphotericin B
Adult dose: 0.5 -1 mg/kg by slow infusion daily or every 2d for up to 8 wks
Non propriety name: lipid-encapsulated amphotericin B
Adult dose: 15 -20 mg/kg total dose over 5 or more days
LICE Infestation
Pediculus humanus capitis
Phthirus pubis
Drug of choice:
Chemical class:
Non propriety name: 1% permethrin
Adult & Pediatric dose: Topically
Chemical class:
Non propriety name: 0.5% malathion
Adult & Pediatric dose: Topically
Alternative Drug:
Chemical class:
Non propriety name: pyrethrins with piperonyl butoxide
Adult & Pediatric dose: Topically
Chemical class: macrocyclic lactones
Non propriety name: ivermectin
Adult & Pediatric dose: 200 ug/kg oral once
LYMPHATIC FILARIASIS
Wucheraria bancrofti
Drug of choice:
Chemical class: piperazine derivatives
Non propriety name: diethylcarbamazine [DEC]
Adult dose: day 1: 50 mg p.c; day 2: 50 mg tid; day 3: 100 mg tid;
days 4-14: 6 mg/kg/d in 3 doses
plus
atihistaminics or corticosteroids (for allergic reactions)
Combinations:
Chemical class: macrocyclic lactones
Non propriety name: ivermectin
Adult dose: 200-400 ug/kg once
plus
Chemical class: benzimidazole carbamates
Non propriety name: albendazole
Adult dose: 400 mg once
Chemoprophylaxis once per year:
DEC: 6 mg/kg or Ivermectin: 400 ug/kg
or
DEC: 6 mg/kg plus Ivermectin: 400 ug/kg
DEC: 6mg/kg plus Albendazole: 400 mg
Alternative Drug: for 14-25 days
Chemical class: benzimidazoles
Non propriety name: mebendazole
Chemical class: imidazothiazoles
Non propriety name: levamizole
Tropical Eosinophilia (TPE)
Drug of choice:
Chemical class: piperazine derivatives
Non propriety name: diethylcarbamazine [DEC]
Adult & Pediatric dose: 6 mg/kg/d in 3 doses x 14d
MALARIA
Plasmodium falciprum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Treatment of Chloroquine-resistant falciparum malaria
Drugs of choice:
Chemical class: chincona alkaloids
Non propriety name: quinine sulfate
Adult dose: 650 mg q8h x 3-7d
Pediatric dose: 25 mg/kg/d in 3 doses x 3-7d
plus
Chemical class: tetracycline
Non propriety name: doxycycline
Adult dose: 100 mg bid x 7d
Pediatric dose: 2 mg/kg/d 7d
or
Chemical class: chincona alkaloids
Non propriety name: quinine sulfate
Adult dose: 650 mg q8h x 3-7d
Pediatric dose: 25 mg/kg/d in 3 doses x 3-7d
plus
Chemical class: diaminopyrimidines - sulfonamides
Non propriety name: pyrimethamine (25 mg) - sulfadoxine (500 mg): (Fansidar)
Adult dose: 3 tablets at once on the last day of quinine
Pediatric dose: < 1 yr.: 1/4 tablet; 1-3 yrs.: 1/2 tablet;
4-8 yrs.: 1 tablet; 9-14 yrs.: 2 tablets
or
Chemical class: chincona alkaloids
Non propriety name: quinine sulfate
Adult dose: 650 mg q8h x 3-7d
Pediatric dose: 25 mg/kg/d in 3 doses x 3-7d
plus
Chemical class: macrolide antibiotic
Non propriety name: clindamycin
Adult dose: 900 mg tid x 5d
Pediatric dose: 20-40 mg/kg/d in 3 doses x 5d
Treatment of multidrug-resistant falciparum malaria
Drugs of choice
Chemical class: 4- quinolinmethanol
Non propriety name: mefloquine (Lariam)
Adult dose: 1250 mg once (750 mg followed 12 hours later by 500 mg)
Pediatric dose: 25 mg/kg/ once (15 mg/kg followed 8-12 hrs. later by 10 mg/kg)
(< 45 kg b.w.)
Chemical class: 9-phenanthrenemethanol
Non propriety name: halofantrine (Halfan)
Adult dose: 500 mg q6h x 3 doses ; repeat in one week
Pediatric dose: 8 mg/kg q6h x 3 doses (< 40 kg); repeat in one week
Chemical class: hydroxynaphthoquinone
Non propriety name: atovaquone (Mepron)
Adult dose: 1000 mg qd x 3d
Pediatric dose: 11-20 kg b.w.: 250 mg; 21-30 kg: 500 mg; 31-40: kg: 750 mg
plus
Chemical class: biguanide
Non propriety name: proguanil (Paludrine)
Adult dose: 400 mg qd x 3d
Pediatric dose: 11-20 kg b.w.: 100 mg; 21-30 kg: 200 mg; 31-40 kg: 300 mg
Chemical class: hydroxynaphthoquinone - biguanide
Non propriety name: atovaquone (250 mg) - proguanil (100 mg) (Malarone)
Adult dose: 4 tablets once/d x 3d
Pediatric dose: once/d x 3d for 11-20 kg b.w.: 1 tablet; 21-30: kg 2 tablets; 31-40 kg:
3 tablets: > 40 kg: 4 tablets
Chemical class: hydroxynaphthoquinone
Non propriety name: atovaquone (Mepron)
Adult dose: 1000 mg qd x 3d
Pediatric dose: 11-20 kg b.w.: 250 mg; 21-30: kg 500 mg; 31-40 kg: 750 mg
plus
Chemical class: tetracycline
Non propriety name: doxycycline
Adult dose: 100 mg bid x 3d
Pediatric dose: 2 mg/kg/d x 3d
Chemical class: dihydroqinghaosu derivative: sodium hydrogen succinate monoester
Non propriety name: sodium artesunate
Adult dose: 4 mg/kg x 3d
Treatment of chloroquine-resistant vivax malaria
Drugs of choice
Chemical class: chincona alkaloid
Non propriety name: quinine sulfate
Adult dose: 650 mg q8h x 3-7d;
Pediatric dose: 25 mg /kg/d in 3 doses x 3-7d
plus
Chemical class: tetracycline
Non propriety name: doxycycline
Adult dose: 100 mg bid x 7d
Pediatric dose: 2 mg/kg/d x 7d
or
Chemical class: chincona alkaloid
Non propriety name: quinine sulfate
Adult dose: 650 mg q8h x 3-7d;
Pediatric dose: 25 mg /kg/d in 3 doses x 3-7d
plus
Chemical class: diaminopyrimidines - sulfonamides
Non propriety name: pyrimethamine (25 mg) - sulfadoxine (500 mg) (Fansidar )
Adult dose: 3 tablets at once on the last day of quinine
Pediatric dose: < 1 yr.: 1/4 tablet; 1-3 yrs.: 1/2 tablet;
4-8 yrs.: 1 tablet; 9-14 yrs.: 2 tablets
or
Chemical class: 4- quinolinmethanol
Non propriety name: mefloquine (Lariam)
Adult dose: 1250 mg once (750 mg followed 12 hours later by 500 mg)
Pediatric dose: 25 mg/kg/ once (15 mg/kg followed 8-12 hrs. later by 10 mg/kg)
Treatment of chloroquine-sensitive plasmodia
Chemical class: 4- aminoquinoline
Non propriety name: chloroquine phosphate (Aralen, Resochin, others)
Adult dose: 1 gram (600 mg base), then 500 mg (300mg base) 6 hrs. later, then
500 mg (300mg base) at 24 and 48 hrs.
Pediatric dose: 10 mg base /kg (max. 600 mg base), then 5 mg base /kg 6 hrs. later, then
5 mg base/kg at 24 and 48 hrs.
or
Chemical class: hydroxychloroquine sulfate 400 mg equivalent to 500 mg chloroquine phosphate
Treatment of severe plasmodial, especially falciparum , malaria
Drugs of choice
Chemical class: D- stereoisomer of quinine
Non propriety name: quinidine gluconate
Adult and pediatric dose: 10 mg/kg loading dose (max. 600 mg) i.v. in normal saline slowly over 1-2 hrs. followed by continuous infusion of 0.02 mg/kg/min until oral therapy can be started.
Chemical class: chincona alkaloid
Non propriety name: quinine dihydrochloride
Adult and pediatric dose: 20 mg/kg loading dose i.v. in 5% dextrose over 4 hrs. followed by 10 mg/kg over 2-4 hrs. q8h (max. 1800 mg/d) until oral therapy can be started.
Alternative drug
Chemical class: qinghauso = artemisinin derivatives
Non propriety name: artemether
Adult and pediatric dose: 3.2 mg/kg i.m. then 1.6 mg/kg qd
Treatment for prevention of relapses (radical cure of benign tertian malaria)
Drug of choice
Chemical class: 8-aminoquinolines
Non propriety name: primaquine phosphate
Adult dose: 26.3 mg (15 mg base)/d x 14 d or 79 mg (45 mg base) /wk x 8 wks.
Pediatric dose: 0.3 mg base /kg/d x 14d
Treatment for prevention of malaria in chloroquine-sensitive areas:
Drug of choice
Chemical class: 4- aminoquinoline
Non propriety name: chloroquine phosphate (Aralen, Resochin, others)
Adult dose: 500 mg (300 mg base) once a week;
Pediatric dose: 5 mg/kg base once a week up to adult dose of 300 mg base
[Prophylaxis is started one week prior to travel, continued weekly for the duration of stay and for 4 weeks after leaving endemic area.]
Treatment for prevention of malaria in chloroquine-resistant areas:
Drug of choice
Chemical class: 4- quinolinmethanol
Non propriety name: mefloquine (Lariam)
Adult dose: 250 mg once / week
Pediatric dose: 5-9 kg:1/8 tablet; 10-19 kg:1/4 tablet; 20-30 kg: 1/2 tablet;
31-45 kg: 3/4 tablet; > 45 kg: 1 tablet / once a week
[Prophylaxis is started one week prior to travel, continued weekly for the duration of stay and for 4 weeks after leaving endemic area.]
or
Chemical class: tetracycline
Non propriety name: doxycycline
Adult dose: 100 mg daily
Pediatric dose: 2 mg/kg/d up to 100 mg/d
or
Chemical class: 8-aminoquinolines
Non propriety name: primaquine phosphate
Adult dose: 30 mg base daily
Pediatric dose: 0.6 mg/kg base daily
or
Chemical class: hydroxynaphthoquinone - biguanide
Non propriety name: atovaquone (250 mg) - proguanil (100 mg) (Malarone)
Adult dose: 1 tablet daily
Pediatric dose: 11-20 kg b.w.: 1/4 tablet daily; 21-30 kg 1/2 tablet daily; 31-40 kg:
1/3 tablet daily: > 40 kg: 1 tablet daily
[Prophylaxis is started1-2 days prior to travel, continued daily for 1 week after leaving endemic area.]
Alternative drugs
Chemical class: 4- aminoquinoline
Non propriety name: chloroquine phosphate (Aralen, Resochin, others)
Adult dose: 500 mg (300 mg base) once a week;
Pediatric dose: 5 mg/kg base once a week up to adult dose of 300 mg base
plus
Chemical class: diaminopyrimidines - sulfonamides
Non propriety name: pyrimethamine (25 mg) - sulfadoxine (500 mg) (Fansidar )
Adult dose: 3 tablets at once
Pediatric dose: < 1 yr.: 1/4 tablet; 1-3 yrs.: 1/2 tablet;
4-8 yrs.: 1 tablet; 9-14 yrs.: 2 tablets
or
Chemical class: 4- aminoquinoline
Non propriety name: chloroquine phosphate (Aralen, Resochin, others)
Adult dose: 250 mg once / week
Pediatric dose: 5-9 kg: 1/8 tablet; 10-19 kg: 1/4 tablet; 20-30 kg: 1/2 tablet;
31-45 3/4 tablet; 45 kg: 1 tablet
plus
Chemical class: biguanide
Non propriety name: proguanil (Paludrine)
Adult dose: 200 mg once daily
Pediatric dose: < 2 yrs.: 50 mg/d; 2-6 yrs.: 100 mg/d; 7-10 yrs.: 150 mg/d;
> 10 yrs.: 200 mg/d / once daily
[Prophylaxis with Proguanil is recommended during exposure and for 4 weeks after leaving endemic area.]
MICROSPORIDIOSIS
Ocular:
Encephalitozoon hellem, Encephalitozoon cuniculi,
Vittaforma corneae (Nosema corneum )
Drug of choice
Chemical class: benzimidazoles
Non propriety name: albendazole
Adult dose: 400 mg bid
plus
Chemical class:
Non propriety name: fumagillin
Adult dose: 60 mg/d PO x 14 d
Intestinal:
Enterocytozoon bieneusi
Drug of choice
Chemical class:
Non propriety name: fumagillin
Adult dose: 60 mg/d PO x 14 d
Encephalitozoon [Septata ] intestinalis
Drug of choice
Chemical class: benzimidazoles
Non propriety name: albendazole
Adult dose: 400 mg bid
Disseminated:
Encephalitozoon hellem, Encephalitozoon cuniculi,
Encephalitozoon [Septata ] intestinalis, Pleistophora sp.,
Trachipleistophora sp., Brachiola vesicularum
Drug of choice
Chemical class: benzimidazoles
Non propriety name: albendazole
Adult dose: 400 mg bid
SCABIES
Sarcoptes scabiei
Drug of choice:
Chemical class:
Non propriety name: 5% permethrin
Adult & Pediatric dose: Topically
Alternative Drug:
Chemical class: macrocyclic lactones
Non propriety name: ivermectin
Adult & Pediatric dose: 200 ug/kg PO once
Chemical class:
Non propriety name: 10% crotamiton
Adult & Pediatric dose: Topically
SCHISTOSOMIASIS
Schistosoma haematobium
Drug of choice:
Chemical class: pyrazinoisoquinolines
Non propriety name: praziquantel
Adult & Pediatric dose: 2 x 20 mg/kg x 1d
Chemical class: organophosphates
Non propriety name: metrifonate
Adult dose: 5-10 mg/kg x 3 at 2 weeks intervals
Alternative Drug:
Chemical class: 5-nitrothiazoles
Non propriety name: niridazole
Adult dose: 25 mg/kg, maximum 1.5 g/d, for 7d
Schistosoma mansoni
Drug of choice:
Chemical class: pyrazinoisoquinolines
Non propriety name: praziquantel
Adult & Pediatric dose: 2 x 20 mg/kg x 1d
Alternative Drug:
Chemical class: tetrahydroquinolines
Non propriety name: oxamniquine
Adult dose: 15 mg/kg once
Pediatric dose: 20 mg/kg/d in 2 doses x 1d, or 30-40 mg/kg
STRONGYLOIDIASIS
Strongyloides stercoralis
Drug of choice:
Chemical class: macrocyclic lactones
Non propriety name: ivermectin
Adult and Pediatricdose: 200 ug/kg/d x 1-2d
Alternative Drug:
Chemical class: benzimidazoles
Non propriety name: thiabendazole
Adult dose: 50 mg/kg/d in 2 doses x 2d, max. 3 gram/d
Non propriety name: albendazole
Adult dose: 400 mg/d x 7d
TAENIASIS
Taenia saginata & Taenia solium
Drug of choice:
Chemical class: salicylanilides
Non propriety name: niclosamide
Adult & Pediatric dose: 2 g once
Chemical class: pyrazinoisoquinolines
Non propriety name: praziquantel
Adult & Pediatric dose: 5-10 mg/kg once
Chemical class: benzimidazole carbamates
Non propriety name: mebendazole
Adult dose: 200 mg bid x 3d
Cysticercus cellulosae
Drug of choice:
Chemical class: benzimidazole carbamates
Non propriety name: albendazole
Adult dose: 400 mg bid x 8-30d
Alternative Drug:
Chemical class: pyrazinoisoquinolines
Non propriety name: praziquantel
Adult dose: 50 mg/kg in 3 doses x 15d
TRICHINOSIS
Trichinella spiralis
Intestinal stages
Drug of choice:
Chemical class: steroids
Non propriety name: corticosteroids
Parentral stages
Drug of choice:
Chemical class: benzimidazoles
Non propriety name: mebendazole
Adult dose: 200-400 mg tid x 3d then 400-500 mg tid x 10d
Non propriety name: albendazole
Adult dose: 400 mg bid x 14d
Pediatric dose: 15 mg/kg bid x 14d
TRICHURIASIS
Trichuris trichuria
Drug of choice (for infective 2 nd. stage larvae in egg shell; hatched 1,2 larvae in mucosa)
Chemical class: benzimidazole carbamates
Non propriety name: mebendazole
Adult and Pediatric dose: 100 mg bid x 3d or 500 mg once
Non propriety name: albendazole
Adult and Pediatric dose: 400 mg once. For heavy infections 400 mg/d x 3d
Drug of choice (for adult worms)
Chemical class: tetrahydropyrimidines
Non propriety name: oxantel pamoate; oxantel / pyrantel pamoate
TOXOCARIASIS [VISCERAL LARVA MIGRANS]
Toxocara canis
Toxocara cati
Drug of choice:
Chemical class: piperazine derivatives
Non propriety name: diethylcarbamazine [DEC]
Adult and Pediatric dose: 6 mg/kg/d in 3 doses x 7-10d
Alternative Drug:
Chemical class: benzimidazole carbamates
Non propriety name: mebendazole
Adult and Pediatric dose: 100-200 mg bid x 5d
Non propriety name: albendazole
Adult and Pediatric dose: 400 mg bid x 3-5d
TOXOPLASMOSIS
Toxoplasma gondii
Drug of choice:
Chemical class: diaminopyrimidines
Non propriety name: pyrimethamine
Adult dose: 25-100 mg/d x 3-4 wks
Pediatric dose: 2mg/kg/d x 3d, then 1 mg/kg/d (max 25 mg/d) x 4 wks
plus
Chemical class: sulfonamides
Non propriety name: sulfadiazine
Adult dose: 1-1.5 g qid x 3-4 wks
Pediatric dose: 100-200 mg/kg/d x 3-4 wks
Alternative Drug:
Chemical class:
Non propriety name: spiramycin
Adult dose: 3-4 grams /d bid x 3-4 wks
Pediatric dose: 50-100 mg/kg/d x 3-4 wks
TRICHOMONIASIS
Trichomonas vaginalis
Drug of choice:
Chemical class: 5-nitrimidazole
Non propriety name: metronidazole
Adult dose: 2 grams once: or 250 mg tid or 350 mg bid x d.
Pediatric dose: 15 mg/kg/d in 3 doses x 7d
Chemical class: 5- nitroimidazole
Non propriety name: tinidazole
Adult dose: 2 grams once
Pediatric dose: 50 mg/kg once (max. 2 g)