FILARIASIS

Treatment

[Brugia malayi] [Brugia timori] [Wuchereria bancrofti]

Drugs:

The three drugs most often prescribed to treat lymphatic filariasis are diethylcarbamaxine (DEC), ivermectin, and albendazole.

DRUG	Dosage (single-dose/kg body weight)	Target	Function	Side-effects
DEC	6 mg	microfilaria	Microfilaricidal, 50% macrofilaricidal	Allergic response (fever, lymphagitis)
Ivermectin	400 ug	microfilaria	Paralyzes microfilaria	Slower onset than DEC, less harsh allergic response
Albendazole	400 mg/adult	Macrofilaria, microfilaria	Micro- and macrofilaricidal	acute pain, fever and inflammation of the scrotal sac and adjacent tissue

Each of these drugs has proven to work in single-drug treatments, but the most efffective treatments have involved combinations of two drugs, namely ivermectin and albendazole. This combination has proven to maximize the filaricidal function of the drugs while minimizing discomforting side effects. Often times, in endemic areas, a single-dose of this combination will be prescribed annually as a preventative measure.

The allergic response to the prescribed drugs occurs because the immune system is dealing with the dead filariae. The same allergic response is seen when the worms die naturally. This allergic response is alleviated by the prescription of antihistamines, analgesics, and antibiotics.

Ivermectin

nema.cap.ed.ac.uk/fgn/ pnb/filpath.html

Surgery:

Surgery is not considered to be a means for eliminating the filariae, but rather as a method for attenuating the symptoms of the disease in its more exacerbated form. The surgical methods for treating scrotal elephantiasis are effective as are those for treating hydrocoele. Surgery on outer limbs affected by elephantiasis have produced more mixed results. Surgical techniques, however, are constantly improving with the technology.

Created by Eric Crossen and Nicole Sandoval Human Biology 103 Parasites and Pestilence             Spring 2004            Instructor: D. Scott Smith, MD