Successful use of parenteral ivermectin in an immunosuppressed patient with disseminated strongyloidiasis and septic shock

Fatal relapse of disseminated strongyloidiasis in an HIV-positive patient, despite ivermectin treatment

“…Ivermectin has been administered as an enema to patients unable to take the drug orally, and there are also reports of parenteral use (Marty et al, 2005;Salluh et al, 2005b). Since parenteral ivermectin has not been approved for use in humans, Marty et al (2005) gave a patient a veterinary formulation of ivermectin (IvomecH; Merial Animal Health, Harlow, U.K.) subcutaneously, with encouraging results.…”

A 56‐Year‐Old Woman with Rash, Paralytic Ileus, and Massive Gastrointestinal Bleeding

“…The oral route for providing ivermectine or thiabendazole was precluded in this patient because of the paralytic ileus. In extreme situations that resembled our case, several case reports disclosed good therapeutic response to a veterinary preparation of ivermectine given by the subcutaneous route [6][7][8][9]. Subcutaneous administration followed by oral treatment with ivermectine was instituted, and the patient recovered uneventfully; however, she developed T cell leukemia lymphoma 1 year later and died after 6 months of unsuccessful chemotherapy and antiviral treatment.…”

Failure of Subcutaneous Ivermectin in Treating Strongyloides Hyperinfection

“…There are six case reports using subcutaneous ivermectin as an adjunct or alternative to oral ivermectin and/or albendazole. [4][5][6][7][8][9] There have also been three case reports on the use of rectal thiabendazole [14][15][16] and one report of rectal ivermectin. 17 Although some of these cases reported success, results were confounded by the coadministration of oral medications and an optimal approach remains unknown.…”

“…There have been six published cases describing use of the parenteral form of ivermectin for treating hyperinfection. [4][5][6][7][8][9] We describe the clinical course of a hypoalbuminemic patient with Strongyloides hyperinfection who was treated with oral followed by subcutaneous ivermectin. This is the first report of total and free ivermectin levels in a patient.…”