Trichinosis (Trichinellosis) Medication

Updated: May 01, 2018
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Burke A Cunha, MD  more...
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Medication

Medication Summary

It is difficult to differentiate the efficacy of drug therapy from natural recovery of infection in mild-to-moderate cases. Factors such as the Trichinella species involved, intensity and length of infection, and host response can aid in deciding on the treatment course. [17] The mainstays of therapy include bed rest, antipyretics, and analgesics. Anthelmintic medications and steroids have a limited role in therapy. If anthelmintic medications are used, the drug of choice is albendazole, because it appears to have the best adverse-effect profile and efficacy.

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Anthelmintics

Class Summary

The benzimidazole drugs albendazole, mebendazole, and thiabendazole are the available medications. These drugs bind helminthic beta-tubulin, which prevents microtubule assembly and inhibits glucose uptake, resulting in parasite immobilization and death.

Albendazole (Albenza)

Decreases ATP production in worms, causing energy depletion, immobilization, and death. To avoid inflammatory response in CNS, administer with anticonvulsants and high-dose glucocorticoids. Available as 200-mg tabs. Practically insoluble in water; absorption enhanced if taken with fatty meal. Good penetration into CNS and better tolerated than thiabendazole.

Mebendazole (Vermox)

Causes worm death by selectively and irreversibly blocking uptake of glucose and other nutrients in susceptible intestine, where helminths dwell. Available as 100-mg chewable tabs.

Thiabendazole (Mintezol)

For mixed helminthic infections; inhibits helminth-specific mitochondrial fumarate reductase; alleviates symptoms of trichinosis during invasive phase. Little value in disease that spreads beyond lumen of intestines; absorption from GI tract is poor. Use limited because of adverse-effect profile. Available in 500-mg tab and 500-mg/5-mL susp. Administer with meals.

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Analgesics

Class Summary

Pain control is essential to quality patient care. Analgesics ensure patient comfort and have sedating properties, which are beneficial for patients with pain.

Acetaminophen (Aspirin-Free Anacin, Tylenol, Feverall)

DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, upper GI disease, or current therapy with oral anticoagulants. Reduces fever by acting directly on hypothalamic heat-regulating centers, which increases dissipation of body-heat via vasodilation and sweating.

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Corticosteroids

Class Summary

Steroids decrease inflammatory response in the host.

Prednisone (Sterapred)

Use in severe infections with signs of shock or significant pulmonary, CNS, or cardiac involvement. Steroids reduce number of worms expelled from GI tract, which may increase number of larvae produced.

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