Ivermectin for Human Strongyloidiasis and other Intestinal Helminths

Authors:
  • GJGerardo Jimenez
    Gerardo Jimenez
  • JGJorge G. Guerra
    Jorge G. Guerra
  • RBRaul Bernal
    Raul Bernal
  • DNDavid R. Nalin
    David R. Nalin
  • DNDonald Neu
    Donald Neu
  • MAMohammed Aziz
    Mohammed Aziz
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Abstract
Since ivermectin, a mixture of 2 closely related macrocyclic lactones, has proven highly effective against animal intestinal nematodes, trials were undertaken to determine its efficacy against human intestinal nematodes. We tested 110 patients with strongyloidiasis and 90 with enterobiasis; many had other intercurrent intestinal nematode infections. Stool examinations were done before and after patients were given a single dose of oral ivermectin capsules (50, 100, 150, or 200 µg/kg body wt); 55 recipients of 100 or 200 µg/kg doses received a second identical dose the next day. Kato and saline smears, ethyl acetate concentration, modified Baermann's technique, and Harada-Mori cultures were repeated; cure was defined as complete absence of eggs and/or larvae from stools tested 30 days after dosing. Ivermectin was well tolerated. Overall cure rates at all doses 30 days after therapy averaged 88% for strongyloidiasis, 100% for ascariasis, 85% for trichuriasis, and 85% for enterobiasis. Ancylostoma duodenale and Necator americanus were little affected.