Whipworm Treatment & Management

Updated: Sep 28, 2023
  • Author: Shipra Gupta, MD; Chief Editor: Russell W Steele, MD  more...
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Treatment

Medical Care

Treatment with broad-spectrum anthelminthic agents is key. Most infections can be treated successfully with mebendazole, albendazole, or ivermectin. These anthelminthic medications should be taken for 3 days. Dosage guidelines and important drug interactions are summarized in the medication section. Albendazole should be taken with food. Ivermectin should be taken with water on an empty stomach and the safety of ivermectin for children weighing less than 15 kg has not been established. Neither albendazole nor ivermectin has been approved by the US Food and Drug Administration (FDA) for treating whipworm.

A systematic review and network meta-analysis by Moser et al reported that T. trichiura cure rates with albendazole and mebendazole were 30.7% and 42.1%, respectively. The study also reported that between 1995 to 2015, albendazole cure rates decreased from 38.6% to 16.4% and egg-reduction rates decreased from 72.6% to 43.4% for albendazole and 91.4% to 54.7% for mebendazole. [11]

The combination of single dose of ivermectin and albendazole, or ivermectin and mebendazole, improves cure rates of 38% and 55% respectively. [12]  Studies have shown that combination therapy with ivermectin and albendazole has higher cure rates than monotherapy with albendazole alone. [13]

Emodepside, a veterinary drug, has shown superior activity against T trichiura when compared with albendazole. It is being studied as a therapeutic candidate to treat trichuriasis and other helminth infections. [14]

Further outpatient care

Reexamination of stool specimens 2 weeks after therapy to determine whether the worms have been eliminated is helpful for assessing therapy. Retreatment may be necessary if symptoms persist 2-3 weeks after initial therapy.

Prevention

Proper disposal of fecal material is indicated. Mass treatment of infected school-aged populations can reduce whipworm transmission in communities with endemic infection.

Some clinicians have suggested periodic deworming programs for children in endemic areas. [15]

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Consultations

Consultations with the following specialists may be appropriate:

  • Infectious diseases specialist

  • Gastroenterologist

  • Hematologist

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