Chemoprophylactic Activity of Flubendazole in Cystic Echinococcosis

Abstract

Background: Cystic echinococcosis (CE) is an important public health problem worldwide. Flubendazole, administered in tablets, has shown poor in vivo efficacy against CE in humans. However, flubendazole prepared as a solution caused a marked reduction in hydatid cysts developed in mice. The goal of the current work was to compare the chemoprophylactic effect of flubendazole formulated either as a hydroxypropyl-β-cyclodextrin solution or as a carboxymethylcellulose suspension in secondary CE in mice. Methods: Balb/C mice were infected with Echinococcus granulosus protoscoleces. One day after infection, the animals were allocated into 3 different experimental groups: unmedicated control and treated at the time point of infection with flubendazole either prepared as a solution or suspension given twice a day during 15 days. Six months after infection, the animals were sacrificed to collect and weight parasitic cysts. Cyst samples recovered from infected mice of each experimental group were prepared for both scanning and transmission electron microscopy. Results: Both flubendazole formulations induced a significant reduction in cyst weight compared to the cysts recovered from the unmedicated control animals. Both formulations showed similar flubendazole-induced ultrastructural morphological changes. Conclusion: Flubendazole offers a great potential to become a drug of choice in the preventive treatment of cystic echinococcosis.

In Vitro and In Vivo Effects of Tamoxifen against Larval Stage Echinococcus granulosus

“…Therefore, TAM may not only reduce the number of cysts that develop but may also inhibit the development of secondary hydatidosis in mice. It is important to highlight the fact that the obtained results coincide with those for other treatment schedules previously assayed (26,27). SEM and TEM evaluations revealed that TAM induces a number of characteristic alterations in the cyst germinal layer.…”

“…SEM and TEM evaluations revealed that TAM induces a number of characteristic alterations in the cyst germinal layer. The ultrastructural changes induced by TAM were similar to those described for other compounds such as albendazole, praziquantel, and flubendazole (26,27), including distorted internal tissue, vacuolated areas, and the presence of abundant lipid droplets.…”

Nematodicidal Activity of Flubendazole and Its Reduced Metabolite on a Murine Model of <b><i>Trichinella spiralis </i></b>Infection

“…It has been previously reported that the use of complexing agents such as cyclodextrins (CD) increases the water solubility of both FLBZ and ABZ [6] and their systemic drug exposure in mice [1,7]. After the oral administration of FLBZ as a solution or suspension, both formulations demonstrated a preventive chemoprophylactic effect in Echinococcus granulosus -infected mice [8]. However, since anthelmintic efficacy of BZD compounds is closely related to the presence of sustained concentrations at the site of parasite location, the improved pharmacokinetic behaviour observed after the administration of FLBZ as a CD solution permits higher drug exposure of the hydatid cysts, which enhances its clinical efficacy in echinococcosis [1].…”

Pericyst Radiofrequency Ablation Treatment for Hepatic Alveolar Echinococcosis

“…Presumably, perioperative anthelmintic treatment with albendazole, mebendazole, and, more recently, flubendazole to reduce cyst size can be restricted to selected cases. 11 In our case, albendazole was administered in 3 cycles of 2 weeks to avoid secondary echinococcosis. 12 Finally, intraoperative microscopic examination for membrane fragments, hooklets, or scolices is rendered unnecessary.…”