Efficacy of Albendazole and Mebendazole With or Without Levamisole for Ascariasis and Trichuriasis

Abstract

BACKGROUND: Helminthiasis in school-aged children potentially causing physical growth and intellectual development retardation. Trichuriasis was the most common type of helminthiasis in children.
 AIM: To investigated the efficacy and side effects of albendazole, albendazole combined with levamisole and mebendazole combined with levamisole for trichuriasis and ascariasis.
 METHODS: This study was conducted as a double-blind, randomised clinical trial by comparing the efficacy and side effects of albendazole, albendazole combined with levamisole and mebendazole combined with levamisole for trichuriasis. The sample of this study were 180 elementary school students at Deli Serdang Regency State Elementary School, Medan, Indonesia. The study was conducted from April to June 2015.
 RESULT: The cure rate of helminthiasis on the 7th day was 81.7% after albendazole therapy, 88.3% after albendazole levamisole therapy, and 83.3% after mebendazole combined with levamisole therapy (p = 0.577). Cure rate on the 14th day was 88.3%, 95%, and 91.7% for albendazole, albendazole combined with levamisole, and mebendazole combined with levamisole therapy, respectively (p = 0.418). On the 21th day, the cure rate was 88.3%, 96.7%, and 91.7% (p = 0.230). Combination of albendazole and levamisole showed the highest cure rate, despite the statistically insignificant difference for all groups (p > 0.05). Combination of albendazole combined with levamisole showed better cure rate for mild trichuriasis (95.8%) than albendazole therapy (46.2%) and mebendazole combined with levamisole (83.3%), (p < 0.05).
 CONCLUSION: Single-dose albendazole, a combination of albendazole and levamisole, and a combination of mebendazole and levamisole had similar efficacy in reducing egg count in helminthiasis. Combination of albendazole and levamisole showed better cure rate for mild trichuriasis and mixed infections. Side effects were similar in all treatment groups.

Trichuris dysentery syndrome, the neglected tropical disease: a case series

“…Moreover, egg reduction (ER) by albendazole was 40%. 12 Mebendazole showed better results with 19% CR, increased to 55% if combined with ivermectin, and 83.3% if combined with levamisole; the ER was 67%. 13 The efficacy of albendazole and mebendazole was better if combined with levamisole or ivermectin, 12,13 but those drugs are not available in Papua, so we used monotherapy in our cases.…”

“…The recommended target populations have expanded from only school-aged children to include Anthelmintic treatment efficacy data against Trichuriasis are limited and varied. A previous study showed that the efficacy of albendazole vs. mebendazole in Trichuriasis was not consistent; one study revealed that albendazole alone had an 88.3% cure rate (CR), 12 but another study reported only a 10% CR. 13 The CR after combination ivermectin treatment was 38%, and after combination with levamisole was 95.8%.…”

Higher efficacy of a single dosage albendazole and different soil-transmitted helminths re-infection profiles amongst indigenous Negritos from inland jungle versus those in resettlement at town peripheries

“…Most studies including a few conducted in Malaysia revealed low curative effect (< 50.0%) of the albendazole against T. trichiura, which reportedly ranged between 4.9-50.0% (Ramalingam et al, 1983;Chien et al, 1989;Sinniah et al, 1990;Albonico et al, 1994;Norhayati et al, 1997;Bennett & Guyatt, 2000;Keiser & Utzinger, 2008). On the other hand, a few studies claimed > 50% cure rate, for instance: 68.9% cure rate in the Philippine (Ovedoff, 1984), 83.9% in Kenya (Bwibo & Pamba, 1984), 52.7% in Haiti (Beach et al, 1999), 76.0% in France and West Africa (Pene et al, 1982) and 81.7% in Indonesia (Anto & Nugraha, 2019). The reason behind these huge disparities is still unknown and many factors have been suggested which includes the possibility of anthelminthic resistance or reduced efficacy of the drugs by underdosing (Vercruysse et al, 2011;Shalaby, 2013).…”

From Bench to Bedside: What Do We Know about Imidazothiazole Derivatives So Far?

“…In the course of anthelmintic treatment, sometimes the clinical treatment method of combined medication is adopted. Anto and Nugraha conducted a double-blind randomized clinical trial to compare the efficacy and side effects of albendazole, albendazole combined with levamisole and mebendazole combined with levamisole in the treatment of trichomoniasis [ 45 ]. The results showed that the cure rate of albendazole combined with levamisole for mild caterpillar disease and mixed infection was better, and the side effects of all treatment groups were similar.…”