Volume 93, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Two cases of hyperinfection are presented. Ivermectin was initially administered orally and per rectum pending the availability of subcutaneous (SC) preparations. In neither case did rectal suppositories of ivermectin achieve clinically meaningful serum values. Clinicians should use SC preparations of ivermectin as early as possible in hyperinfection and dissemination.


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  1. Kitzman D, Wei S-Y, Fleckenstein L, , 2006. Liquid chromatographic assay of ivermectin in human plasma for application to clinical pharmacokinetic studies. J Pharm Biomed Anal 40: 10131020.[Crossref] [Google Scholar]
  2. Satoh M, Kiyuna S, Shiroma Y, Toma H, Kokaze A, Sato Y, , 2003. Predictive markers for development of strongyloidiasis in patients infected with both Strongyloides stercoralis and HTLV-1. Clin Exp Immunol 133: 391396.[Crossref] [Google Scholar]
  3. Nonaka D, Takaki K, Tanaka M, Umeno M, Takeda T, Yoshida M, Haraguch Y, Okada K, Sawae Y, , 1998. Paralytic ileus due to strongyloidiasis: case report and review of the literature. Am J Trop Med Hyg 59: 535538. [Google Scholar]
  4. Chiodini PL, Reid AJ, Wiselka MJ, Firmin R, Foweraker J, , 2000. Parenteral ivermectin in Strongyloides hyperinfection. Lancet 355: 4344.[Crossref] [Google Scholar]
  5. Marty FM, Lowry CM, Rodriguez M, Milner DA, Pieciak WS, Sinha A, Fleckenstein L, Baden LR, , 2005. Treatment of human disseminated strongyloidiasis with a parenteral veterinary formulation of ivermectin. Clin Infect Dis 41: e5e8.[Crossref] [Google Scholar]
  6. Pacanowski J, Santos MD, Roux A, Le Maignan C, Guillot J, Lavarde V, Cornet M, , 2005. Subcutaneous ivermectin as a safe salvage therapy in Strongyloides stercoralis hyperinfection syndrome: a case report. Am J Trop Med Hyg 73: 122124. [Google Scholar]
  7. Hauber HP, Galle J, Chiodini PL, Rupp J, Birke R, Vollmer E, Zabel P, Lange C, , 2005. Fatal outcome of a hyperinfection syndrome despite successful eradication of Strongyloides with subcutaneous ivermectin. Infection 33: 383386.[Crossref] [Google Scholar]
  8. Turner SA, Maclean JD, Fleckenstein L, Greenaway C, , 2005. Parenteral administration of ivermectin in a patient with disseminated strongyloidiasis. Am J Trop Med Hyg 73: 911914. [Google Scholar]
  9. Leung V, Al-Rawahi GN, Grant J, Fleckenstein L, Bowie W, , 2008. Case report: failure of subcutaneous ivermectin in treating Strongyloides hyperinfection. Am J Trop Med Hyg 79: 853855. [Google Scholar]
  10. Lichtenberger P, Rosa-Cunha I, Morris M, Nishida S, Akpinar E, Gaitan J, Tzakis A, Doblecki-Lewis S, , 2009. Hyperinfection strongyloidiasis in a liver transplant recipient treated with parenteral ivermectin. Transpl Infect Dis 11: 137142.[Crossref] [Google Scholar]
  11. Grein JD, Mathisen GE, Donovan S, Fleckenstein L, , 2010. Serum ivermectin levels after enteral and subcutaneous administration for Strongyloides hyperinfection: a case report. Scand J Infect Dis 42: 234236.[Crossref] [Google Scholar]
  12. Fusco DN, Downs JA, Satlin MJ, Pahuja M, Ramos L, Barie PS, Fleckenstein L, Murray HW, , 2010. Non-oral treatment with ivermectin for disseminated strongyloidiasis. Am J Trop Med Hyg 83: 879883.[Crossref] [Google Scholar]
  13. Guzzo CA, Furtek CI, Porras AG, Chen C, Tipping R, Clineschmidt CM, Sciberras DG, Hsieh JYK, Lasseter KC, , 2002. Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects. J Clin Pharmacol 42: 11221133.[Crossref] [Google Scholar]
  14. Tarr PE, Miele PS, Peregoy KS, Smith MA, Neva FA, Lucey DR, , 2003. Case report: rectal administration of ivermectin to a patient with Strongyloides hyperinfection syndrome. Am J Trop Med Hyg 68: 453455. [Google Scholar]
  15. Satou T, Koga M, Koike K, Tada I, Nikaido T, , 2001. Nematocidal activities of thiabendazole and ivermectin against the larvae of Strongyloides ratti and S. venezuelensis . Vet Parasitol 99: 311322.[Crossref] [Google Scholar]
  16. Boken DJ, Leoni PA, Preheim LC, , 1993. Treatment of Strongyloides stercoralis hyperinfection syndrome with thiabendazole administered per rectum. Clin Infect Dis 16: 123126.[Crossref] [Google Scholar]

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  • Received : 27 Jan 2015
  • Accepted : 11 Mar 2015
  • Published online : 08 Jul 2015

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