Comparison of two single-day regimens of triclabendazole for the treatment of human pulmonary paragonimiasis

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene 2003-07, Vol.97 (4), p.451-454
• Main Authors: Manuel Calvopiña, H., Guderian, Ronald H., Paredes, Wilson Y., J. Cooper, Philip
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anthelmintics - administration & dosage; Anthelmintics - adverse effects; Anthelmintics - therapeutic use; Benzimidazoles - administration & dosage; Benzimidazoles - adverse effects; Benzimidazoles - therapeutic use; Biological and medical sciences; Child; Child, Preschool; Diseases caused by trematodes; Distomatoses; Drug Administration Schedule; Ecuador; efficacy; Female; Follow-Up Studies; Helminthic diseases; Humans; Infectious diseases; Lung Diseases, Parasitic - drug therapy; Lung Diseases, Parasitic - parasitology; Male; Medical sciences; Middle Aged; paragonimiasis; Paragonimiasis - drug therapy; Paragonimiasis - parasitology; Paragonimus spp; Parasite Egg Count; Parasitic diseases; Sputum - parasitology; Treatment Outcome; Triclabendazole
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/S0035-9203(03)90088-5

A well-tolerated single-day treatment regimen is required for the community-based treatment of pulmonary paragonimiasis. To identify an optimal single-day treatment regimen, an open clinical trial was performed to compare the efficacy of 2 single-day regimens of triclabendazole. From 1991 to 1993, a total of 154 Ecuadorian patients were allocated to receive either a single dose or 2 doses of 10 mg/kg triclabendazole. Treatment with both regimens was associated with a rapid parasitological response (determined by clearance of Paragonimus eggs from sputum), resolution of most clinical symptoms and radiological signs, and only mild adverse effects. At 3 months after treatment, the cure rate (clearance of eggs from sputum) was 90.9% in the 2-dose group and 84.4% in the single-dose group. Re-treatment with a second 2-dose regimen was curative in all remaining patients by 1 year of follow-up. Our findings show that both single-day treatment regimens of triclabendazole were highly effective in the treatment of pulmonary paragonimiasis and suggest that patients should be re-examined at 3 months to determine the need for repeat treatment.