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Non-Oral Treatment with Ivermectin for Disseminated Strongyloidiasis

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  • Division of Infectious Diseases, and Departments of Surgery and Public Health, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York; Pharmacy Department, New York-Presbyterian Hospital, New York, New York; Division of Pharmaceutics and Experimental Therapeutics, University of Iowa College of Pharmacy, Iowa City, Iowa

Critically ill patients with disseminated strongyloidiasis may not be candidates for oral treatment. We report four patients with disseminated strongyloidiasis, believed to be unable to absorb oral therapy, who were treated with ivermectin by rectal and/or subcutaneous administration. Obtaining subcutaneous ivermectin and dosing it appropriately is a challenge. These cases underscore the need for improved access to subcutaneous ivermectin and more pharmacological data to guide use of this treatment approach.

Author Notes

*Address correspondence to Dahlene N. Fusco, Massachusetts General Hospital, 55 Fruit Street, Boston MA 02114. E-mail: dnfusco@partners.org

Financial support: This study was supported by grants T32 AI 007613 (Dahlene N. Fusco, Michael J. Satlin, and Meera Pahuja) and T32 HS000066 (Jennifer A. Downs).

Authors' addresses: Dahlene N. Fusco, Massachusetts General Hospital, Boston MA, E-mail: dnfusco@partners.org. Jennifer A. Downs, Michael J. Satlin, Meera Pahuja, and Henry W. Muray, Division of Infectious Diseases, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, E-mails: jna2002@med.cornell.edu, mjs9012@med.cornell.edu, mep2002@med.cornell.edu, and hwmurray@med.cornell.edu. Liz Ramos, Pharmacy Department, New York-Presbyterian Hospital, New York, NY, E-mail: lir9012@nyp.org. Philip S. Barie, Departments of Surgery and Public Health, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, E-mail: pbarie@med.cornell.edu. Lawrence Fleckenstein, Division of Pharmaceutics and Experimental Therapeutics, University of Iowa College of Pharmacy, Iowa City, IA, E-mail: l-fleckenstein@uiowa.edu.

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