Long‐Term Evaluation of Patients with Hydatidosis Treated with Benzimidazole Carbamates

Abstract

Four hundred forty-eight patients with 929 Echinococcus granulosus hydatid cysts received 3- to 6-month continuous cycles of mebendazole or albendazole treatment and underwent prolonged follow-up by clinical visits and imaging studies (range, 1-14 years) to assess the long-term outcome of treatment. Degenerative changes and relapse were assessed by imaging techniques. At the end of therapy, 74.1% of the hydatid cysts showed degenerative changes. These were more frequent in albendazole-treated than in mebendazole-treated cysts (82.2% vs. 56.1%; P < .001). During long-term follow-up, 104 cysts (22%) had degenerative changes that progressed, whereas 163 cysts (approximately 25%) relapsed. The percentages of relapses in the two drug-treated groups were almost the same. Relapses occurred more frequently in type II cysts of the liver. Cysts recurred most often (78.5%; P < .001) within the first 2 years after treatment ended. Further chemotherapy cycles induced degenerative changes in >90% of relapsed cysts without inducing more frequent or more severe side effects than those observed during the initial cycles.

Evaluation of Nitazoxanide for the Treatment of Disseminated Cystic Echinococcosis: Report of Five Cases and Literature Review

“…32 Monthly cyclic treatment with 14-day intervals was originally recommended, but continuous therapy for 3 to 6 months or longer has demonstrated equal or even improved efficacy without an increase in adverse events. 33 Common adverse reactions associated with albendazole treatment are elevation of transaminases (14.7%), hair loss (2.8%), headache (2.1%), reversible leucopenia (1.2%), and bone marrow toxicity (0.1%) that may lead to treatment interruption in less than 4% of patients.…”

Uncomplicated Hydatid Cysts of the Liver: Clinical Presentation, Diagnosis and Treatment

“…For medical treatment, Albendazole has been proven to be superior to other medical agents in randomized trials [36].…”

Echinococcosis/Hydatidosis

“…There are two main drugs for chemotherapy: albendazole (10-15 mg/kg/day twice per day; 3-to more than 6 monthly courses with free intervals of 14 days) for treating patients with single or multiple cysts (Gemmell & Roberts, 1995), and mebendazole (40-50 mg/kg/day; everyday in three doses per day during 3-6 months). Albendazole continuous courses have shown equal or improved efficacy for 3 to 6 months or longer without an increase of adverse effects (Franchi et al, 1999). When comparing both drugs, albendazole and mebendazole, some researchers concluded that albendazole was better regarding complete cure rates and relieve of the symptoms (Franchi et al, 1999).…”

“…Albendazole continuous courses have shown equal or improved efficacy for 3 to 6 months or longer without an increase of adverse effects (Franchi et al, 1999). When comparing both drugs, albendazole and mebendazole, some researchers concluded that albendazole was better regarding complete cure rates and relieve of the symptoms (Franchi et al, 1999). Albendazole has a better pharmacokinetic profile than mebendazole facilitating higher intestinal absorption and penetration into the cysts.…”