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Efficacy of Diverse Antiparasitic Treatments for Cysticercosis in the Pig Model

Armando E. GonzalezSchool of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru; Department of Microbiology, School of Sciences, and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru

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Javier A. BustosSchool of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru; Department of Microbiology, School of Sciences, and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru

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Juan A. JimenezSchool of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru; Department of Microbiology, School of Sciences, and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru

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Mary L. RodriguezSchool of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru; Department of Microbiology, School of Sciences, and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru

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Mercy G. RamirezSchool of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru; Department of Microbiology, School of Sciences, and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru

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Robert H. GilmanSchool of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru; Department of Microbiology, School of Sciences, and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru

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Hector H. GarciaSchool of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru; Department of Microbiology, School of Sciences, and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru

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Taenia solium cysticercosis infects pigs and humans. Because antiparasitic treatment for human cysticercosis has sub-optimal efficacy, alternative regimes are needed. Seven antiparasitic regimens were tested in 42 naturally infected pigs with cysticercosis, and compared with prednisone alone (n = 6) or no treatment (n = 6). The numbers of viable cysts in muscles and in the brain were examined after necropsy and were significantly decreased in pigs receiving combined albendazole plus praziquantel, albendazole alone, or oxfendazole. Pigs receiving praziquantel alone and nitazoxanide had numerous surviving cysts. Control (untreated) pigs and prednisone-treated pigs had many more viable cysts, suggesting no effect. Combined albendazole plus praziquantel, and oxfendazole, showed a strong cysticidal effect and provide suitable alternative treatments to be further explored for their use for treatment of human neurocysticercosis.

Author Notes

*Address correspondence to Hector H. Garcia, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru H. Delgado 430, SMP, Lima 31, Peru. E-mail: hgarcia@jhsph.edu

Financial support: This study was partially supported by Fogarty International Center/National Institutes of Health (training grant no. TW001140) and the Bill and Melinda Gates Foundation (grant no. 23981). Hector H. Garcia is a Wellcome Trust Senior Research Fellow.

Authors' addresses: Armando E. Gonzalez and Mercy G. Ramirez, School of Veterinary Medicine, Avenida Circunvalacion 2800, San Borja, Lima, Peru, E-mails: agonzale@jhsph.edu and mercyvet@gmail.com. Javier A. Bustos, Juan A. Jimenez, Mary L. Rodriguez, and Hector H. Garcia, Department of Microbiology, School of Sciences and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru, H. Delgado 430, SMP, Lima, Peru, and Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru, E-mails: javier@peruresearch.org, jajch@hotmail.com, mary_luz_rodriguez@hotmail.com, and hgarcia@jhsph.edu. Robert H. Gilman, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, E-mail: rgilman@jhsph.edu.

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