Ivermectin for Human Strongyloidiasis and other Intestinal Helminths

Cesar Naquira Instituto de Medicina Tropical Daniel A. Carrion, Universidad Nacional Mayor de San Marcos, Merck Sharp & Dohme, Universidad del Valle, Merck Sharp & Dohme Research Laboratories, Lima, Peru

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Gerardo Jimenez Instituto de Medicina Tropical Daniel A. Carrion, Universidad Nacional Mayor de San Marcos, Merck Sharp & Dohme, Universidad del Valle, Merck Sharp & Dohme Research Laboratories, Lima, Peru

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Jorge G. Guerra Instituto de Medicina Tropical Daniel A. Carrion, Universidad Nacional Mayor de San Marcos, Merck Sharp & Dohme, Universidad del Valle, Merck Sharp & Dohme Research Laboratories, Lima, Peru

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Raul Bernal Instituto de Medicina Tropical Daniel A. Carrion, Universidad Nacional Mayor de San Marcos, Merck Sharp & Dohme, Universidad del Valle, Merck Sharp & Dohme Research Laboratories, Lima, Peru

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David R. Nalin Instituto de Medicina Tropical Daniel A. Carrion, Universidad Nacional Mayor de San Marcos, Merck Sharp & Dohme, Universidad del Valle, Merck Sharp & Dohme Research Laboratories, Lima, Peru

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Donald Neu Instituto de Medicina Tropical Daniel A. Carrion, Universidad Nacional Mayor de San Marcos, Merck Sharp & Dohme, Universidad del Valle, Merck Sharp & Dohme Research Laboratories, Lima, Peru

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Mohammed Aziz Instituto de Medicina Tropical Daniel A. Carrion, Universidad Nacional Mayor de San Marcos, Merck Sharp & Dohme, Universidad del Valle, Merck Sharp & Dohme Research Laboratories, Lima, Peru

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Since ivermectin, a mixture of 2 closely related macrocyclic lactones, has proven highly effective against animal intestinal nematodes, trials were undertaken to determine its efficacy against human intestinal nematodes. We tested 110 patients with strongyloidiasis and 90 with enterobiasis; many had other intercurrent intestinal nematode infections. Stool examinations were done before and after patients were given a single dose of oral ivermectin capsules (50, 100, 150, or 200 µg/kg body wt); 55 recipients of 100 or 200 µg/kg doses received a second identical dose the next day. Kato and saline smears, ethyl acetate concentration, modified Baermann's technique, and Harada-Mori cultures were repeated; cure was defined as complete absence of eggs and/or larvae from stools tested 30 days after dosing.

Ivermectin was well tolerated. Overall cure rates at all doses 30 days after therapy averaged 88% for strongyloidiasis, 100% for ascariasis, 85% for trichuriasis, and 85% for enterobiasis. Ancylostoma duodenale and Necator americanus were little affected.

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