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Trichuris Trichiura: Treatment & Medication
Updated: May 5, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Treatment
Emergency Department Care
Effective anthelmintic therapy is available (see Medication).
Consultations
Specialty consultation is not necessary unless rectal prolapse or severe anemia is present; both are rare.
Medication
The drug of choice for trichuriasis is mebendazole. A single dose of 500 mg can results in a cure rate of 40-75%. Albendazole is an alternative drug. However, its efficacy for trichuriasis is slightly lower than for mebendazole.
Anthelmintic agents
Parasite biochemical pathways are sufficiently different from the human host to allow selective interference by chemotherapeutic agents in relatively small doses.
Mebendazole (Vermox)
Causes worm death by selectively and irreversibly blocking glucose uptake and other nutrients in the susceptible adult intestine where helminths dwell.
Administer a second course if patient is not cured within 3-4 wk.
Adult
100 mg PO bid for 3 d for individual patients or a single dose of 500 mg in a community setting that requires treatment of large numbers of infected patients
Pediatric
<2 years: Not established
>2 years: Administer as in adults
Carbamazepine and phenytoin may decrease effects; cimetidine may increase levels
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Adjust dose in hepatic impairment
Albendazole (Albenza)
Decreases whipworm ATP production, causing energy depletion, immobilization, and death.
Adult
400 mg/d PO in single dose; repeat in 3 wk if patient is not cured
Pediatric
<2 years: 200 mg/d PO in a single dose; repeat in 3 wk if infestation persists
>2 years: Administer as in adults
Carbamazepine may increase metabolism and decrease its efficacy; conversely, dexamethasone and praziquantel may increase plasma levels when coadministered
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Discontinue use if liver function tests increase significantly
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| Differential Diagnoses & Workup: Trichuris Trichiura |
Treatment & Medication: Trichuris Trichiura |
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References
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Williams-Blangero S, Vandeberg JL, Subedi J, Jha B, Dyer TD, Blangero J. Two quantitative trait loci influence whipworm (Trichuris trichiura) infection in a Nepalese population. J Infect Dis. Apr 15 2008;197(8):1198-203. [Medline].
Bartoloni A, Guglielmetti P, Cancrini G. Comparative efficacy of a single 400 mg dose of albendazole or mebendazole in the treatment of nematode infections in children. Trop Geogr Med. 1993;45(3):114-6. [Medline].
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Jackson TF, Epstein SR, Gouws E. A comparison of mebendazole and albendazole in treating children with Trichuris trichiura infection in Durban, South Africa. S Afr Med J. 1998;88(7):880-883. [Medline].
Jongsuksuntigul P, Jeradit C, Pornpattanakul S. A comparative study on the efficacy of albendazole and mebendazole in the treatment of ascariasis, hookworm infection and trichuriasis. Southeast Asian J Trop Med Public Health. Dec 1993;24(4):724-9. [Medline].
Kongsbak K, Wahed MA, Friis H, Thilsted SH. Acute-phase protein levels, diarrhoea, Trichuris trichiura and maternal education are predictors of serum retinol: a cross-sectional study of children in a Dhaka slum, Bangladesh. Br J Nutr. Oct 2006;96(4):725-34. [Medline].
Kringel H, Iburg T, Dawson H, et al. A time course study of immunological responses in Trichuris suis infected pigs demonstrates induction of a local type 2 response associated with worm burden. Int J Parasitol. Jul 2006;36(8):915-924. [Medline].
Uga S, Nagnaen W, Chongsuvivatwong V. Contamination of soil with parasite eggs and oocysts in southern Thailand. Southeast Asian J Trop Med Public Health. 1997;28 Suppl 3:14-7. [Medline].
Further Reading
Keywords
whipworm, trichuriasis, Trichuris trichiura, intestinal helminthic infection, whipworm infection
Treatment & Medication: Trichuris Trichiura