Safety of the Combined Use of Praziquantel and Albendazole in the Treatment of Human Hydatid Disease

Lucía Alvela-Suárez Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; General Hospital of Palencia “Rio Carrión,” Palencia, Spain

Search for other papers by Lucía Alvela-Suárez in
Current site
Google Scholar
PubMed
Close
,
Virginia Velasco-Tirado Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; General Hospital of Palencia “Rio Carrión,” Palencia, Spain

Search for other papers by Virginia Velasco-Tirado in
Current site
Google Scholar
PubMed
Close
,
Moncef Belhassen-Garcia Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; General Hospital of Palencia “Rio Carrión,” Palencia, Spain

Search for other papers by Moncef Belhassen-Garcia in
Current site
Google Scholar
PubMed
Close
,
Ignacio Novo-Veleiro Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; General Hospital of Palencia “Rio Carrión,” Palencia, Spain

Search for other papers by Ignacio Novo-Veleiro in
Current site
Google Scholar
PubMed
Close
,
Javier Pardo-Lledías Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; General Hospital of Palencia “Rio Carrión,” Palencia, Spain

Search for other papers by Javier Pardo-Lledías in
Current site
Google Scholar
PubMed
Close
,
Angela Romero-Alegría Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; General Hospital of Palencia “Rio Carrión,” Palencia, Spain

Search for other papers by Angela Romero-Alegría in
Current site
Google Scholar
PubMed
Close
,
Luis Pérez del Villar Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; General Hospital of Palencia “Rio Carrión,” Palencia, Spain

Search for other papers by Luis Pérez del Villar in
Current site
Google Scholar
PubMed
Close
,
María Paz Valverde-Merino Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; General Hospital of Palencia “Rio Carrión,” Palencia, Spain

Search for other papers by María Paz Valverde-Merino in
Current site
Google Scholar
PubMed
Close
, and
Miguel Cordero-Sánchez Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; General Hospital of Palencia “Rio Carrión,” Palencia, Spain

Search for other papers by Miguel Cordero-Sánchez in
Current site
Google Scholar
PubMed
Close
Restricted access

There is still no well-established consensus about the clinical management of hydatidosis. Currently, surgery continues to be the first therapeutic option, although treatment with anti-parasitic drugs is indicated as an adjuvant to surgery to decrease the number of relapses and hydatid cyst size. When surgery is not possible, medical treatment is indicated. Traditionally, albendazole was used in monotherapy as the standard treatment. However, combined therapy with albendazole plus praziquantel appears to improve anti-parasitic effectiveness. To date, no safety studies focusing on such combined therapy have been published for the treatment of hydatidosis. In this work, we analyze the adverse effects seen in 57 patients diagnosed with hydatidosis who were treated with praziquantel plus albendazole combined therapy between 2006 and 2010.

Author Notes

* Address correspondence to Lucía Alvela-Suárez, Paseo de San Vicente sn, Salamanca, 37007. E-mail: luciaalvela@hotmail.com

Authors' addresses: Lucía Alvela-Suárez, Virginia Velasco-Tirado, and Ignacio Novo-Veleiro, CAUSA, Internal Medicine, Salamanca, Spain, E-mails: luciaalvela@hotmail.com, virvela@yahoo.es, and ignacio.novo.veleiro@gmail.com. Moncef Belhassen-Garcia, CAUSA, Internal Medicina and Infectious Diseases, Salamanca, Spain, E-mail: mbelhassen@hotmail.com. Javier Pardo-Lledías, General Hospital of Palencia “Río Carrión” - Internal Medicine, Palencia, Spain, E-mail: javipard2@hotmail.com. Angela Romero-Alegría, CAUSA, Internal Medicine, Salamanca, Spain, E-mail: aralegria@yahoo.es. Luis Pérez del Villar, University of Salamanca - CIETUS, IBSAL, Salamanca, Spain, E-mail: luipmoro@usal.es. María Paz Valverde-Merino, CAUSA, Pharmacy Service, Salamanca, Spain, E-mail: mpvalverde@saludcastillayleon.es. Miguel Cordero-Sánchez, CAUSA, Infectious Diseases, Salamanca, Spain, E-mail: magnus@usal.es.

  • 1.

    Budke CM, Deplazes P, Torgerson PR, 2006. Global socioeconomic impact of cystic echinococcosis. Emerg Infect Dis 12: 296303.

  • 2.

    Hotez PJ, Molyneux DH, Fenwick A, Kumaresan J, Sachs SE, Sachs JD, Savioli L, 2007. Control of neglected tropical diseases. N Engl J Med 357: 10181027.

  • 3.

    Seimenis A, 2003. Overview of the epidemiological situation on echinococcosis in the Mediterranean region. Acta Trop 85: 191195.

  • 4.

    Sotiraki S, Himonas C, Korkoliakou P, 2003. Hydatidosis-echinococcosis in Greece. Acta Trop 85: 197201.

  • 5.

    Lorenzini R, Ruggieri A, 1987. Distribution of echinococcosis/hydatidosis in Italy. J Helminthol 61: 261267.

  • 6.

    Rojo-Vazquez FA, Pardo-Lledias J, Francos-Von Hunefeld M, Cordero-Sanchez M, Alamo-Sanz R, Hernandez-Gonzalez A, Brunetti E, Siles-Lucas M, 2011. Cystic echinococcosis in Spain: current situation and relevance for other endemic areas in Europe. PLoS Negl Trop Dis 5: e893.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Pardo J, Muro A, Galindo I, Cordero M, Carpio A, Siles-Lucas M, 2005. Hydatidosis in the province of Salamanca (Spain): should we let down our guard? Enferm Infecc Microbiol Clin 23: 266269.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Vuitton DA, 2009. Benzimidazoles for the treatment of cystic and alveolar echinococcosis: what is the consensus? Expert Rev Anti Infect Ther 7: 145149.

  • 9.

    WHO, 1996. Guidelines for treatment of cystic and alveolar echinococcosis in humans. WHO Informal Working Group on Echinococcosis. Bull World Health Organ 74: 231242.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Menezes da Silva A, 2003. Hydatid cyst of the liver-criteria for the selection of appropriate treatment. Acta Trop 85: 237242.

  • 11.

    Smego RA Jr, Sebanego P, 2005. Treatment options for hepatic cystic echinococcosis. Int J Infect Dis 9: 6976.

  • 12.

    Silva MA, Mirza DF, Bramhall SR, Mayer AD, McMaster P, Buckels JA, 2004. Treatment of hydatid disease of the liver. Evaluation of a UK experience. Dig Surg 21: 227233, discussion 233–234.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Pelaez V, Kugler C, Correa D, Del Carpio M, Guangiroli M, Molina J, Marcos B, Lopez E, 2000. PAIR as percutaneous treatment of hydatid liver cysts. Acta Trop 75: 197202.

  • 14.

    Ustunsoz B, Akhan O, Kamiloglu MA, Somuncu I, Ugurel MS, Cetiner S, 1999. Percutaneous treatment of hydatid cysts of the liver: long-term results. AJR Am J Roentgenol 172: 9196.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Filice C, Brunetti E, Bruno R, Crippa FG, 2000. Percutaneous drainage of echinococcal cysts (PAIR–puncture, aspiration, injection, reaspiration): results of a worldwide survey for assessment of its safety and efficacy. WHO-Informal Working Group on Echinococcosis-Pair Network. Gut 47: 156157.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Perez-Molina JA, Diaz-Menendez M, Gallego JI, Norman F, Monge-Maillo B, Ayala AP, Lopez-Velez R, 2011. Evaluation of nitazoxanide for the treatment of disseminated cystic echinococcosis: report of five cases and literature review. Am J Trop Med Hyg 84: 351356.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Mohamed AE, Yasawy MI, Al Karawi MA, 1998. Combined albendazole and praziquantel versus albendazole alone in the treatment of hydatid disease. Hepatogastroenterology 45: 16901694.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Yasawy MI, al Karawi MA, Mohamed AR, 1993. Combination of praziquantel and albendazole in the treatment of hydatid disease. Trop Med Parasitol 44: 192194.

  • 19.

    El-On J, 2003. Benzimidazole treatment of cystic echinococcosis. Acta Trop 85: 243252.

  • 20.

    Falagas ME, Bliziotis IA, 2007. Albendazole for the treatment of human echinococcosis: a review of comparative clinical trials. Am J Med Sci 334: 171179.

  • 21.

    Stojkovic M, Zwahlen M, Teggi A, Vutova K, Cretu CM, Virdone R, Nicolaidou P, Cobanoglu N, Junghanss T, 2009. Treatment response of cystic echinococcosis to benzimidazoles: a systematic review. PLoS Negl Trop Dis 3: e524.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Horton RJ, 1997. Albendazole in treatment of human cystic echinococcosis: 12 years of experience. Acta Trop 64: 7993.

  • 23.

    Cobo F, Yarnoz C, Sesma B, Fraile P, Aizcorbe M, Trujillo R, Diaz-de-Liano A, Ciga MA, 1998. Albendazole plus praziquantel versus albendazole alone as a pre-operative treatment in intra-abdominal hydatisosis caused by Echinococcus granulosus. Trop Med Int Health 3: 462466.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Haralabidis S, Diakou A, Frydas S, Papadopoulos E, Mylonas A, Patsias A, Roilides E, Giannoulis E, 2008. Long-term evaluation of patients with hydatidosis treated with albendazole and praziquantel. Int J Immunopathol Pharmacol 21: 429435.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Jamshidi M, Mohraz M, Zangeneh M, Jamshidi A, 2008. The effect of combination therapy with albendazole and praziquantel on hydatid cyst treatment. Parasitol Res 103: 195199.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Salto E, Juarez E, Roiz MP, Abad J, 1991. Combined chemotherapy (mebendazole plus praziquantel) in patients with hydatidosis. Enferm Infecc Microbiol Clin 9: 527529.

  • 27.

    Jevtic M, Mikic D, Arsic-Komljenovic G, Stankovic N, Ristanovic E, Sjenicic G, Janicijevic-Hudomal S, 2008. Adverse effects of long term, continual administration of high doses of albendazole in the treatment of echinococcal disease. Vojnosanit Pregl 65: 539544.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Shen C, Choi MH, Bae YM, Yu G, Wang S, Hong ST, 2007. A case of anaphylactic reaction to praziquantel treatment. Am J Trop Med Hyg 76: 603605.

  • 29.

    el-Hawey AM, Massoud AM, el-Rakieby A, Rozeik MS, Nassar MO, 1990. Side effects of praziquantel in bilharzial children on a field level. J Egypt Soc Parasitol 20: 599605.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Lima RM, Ferreira MA, de Jesus Ponte Carvalho TM, Dumet Fernandes BJ, Takayanagui OM, Garcia HH, Coelho EB, Lanchote VL, 2011. Albendazole-praziquantel interaction in healthy volunteers: kinetic disposition, metabolism and enantioselectivity. Br J Clin Pharmacol 71: 528535.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Namwanje H, Kabatereine N, Olsen A, 2011. A randomized controlled clinical trial on the safety of co-administration of albendazole, ivermectin and praziquantel in infected schoolchildren in Uganda. Trans R Soc Trop Med Hyg 105: 181188.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Kaur S, Singhi P, Singhi S, Khandelwal N, 2009. Combination therapy with albendazole and praziquantel versus albendazole alone in children with seizures and single lesion neurocysticercosis: a randomized, placebo-controlled double blind trial. Pediatr Infect Dis J 28: 403406.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Mohammed KA, Haji HJ, Gabrielli AF, Mubila L, Biswas G, Chitsulo L, Bradley MH, Engels D, Savioli L, Molyneux DH, 2008. Triple co-administration of ivermectin, albendazole and praziquantel in Zanzibar: a safety study. PLoS Negl Trop Dis 2: e171.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    WHO, 2003. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 85: 253261.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Witassek F, Burkhardt B, Eckert J, Bircher J, 1981. Chemotherapy of alveolar echinococcosis. Comparison of plasma mebendazole concentrations in animals and man. Eur J Clin Pharmacol 20: 427433.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Morris DL, Taylor DH, 1988. Optimal timing of post-operative albendazole prophylaxis in E. granulosus. Ann Trop Med Parasitol 82: 6566.

  • 37.

    Gollackner B, Langle F, Auer H, Maier A, Mittlbock M, Agstner I, Karner J, Langer F, Aspock H, Loidolt H, Rockenschaub S, Steininger R, 2000. Radical surgical therapy of abdominal cystic hydatid disease: factors of recurrence. World J Surg 24: 717721.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Gavidia CM, Gonzalez AE, Barron EA, Ninaquispe B, Llamosas M, Verastegui MR, Robinson C, Gilman RH, 2010. Evaluation of oxfendazole, praziquantel and albendazole against cystic echinococcosis: a randomized clinical trial in naturally infected sheep. PLoS Negl Trop Dis 4: e616.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Morris DL, Richards KS, Clarkson MJ, Taylor DH, 1990. Comparison of albendazole and praziquantel therapy of Echinococcus granulosus in naturally infected sheep. Vet Parasitol 36: 8390.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Haralabidis S, Diakou A, Frydas S, Papadopoulos E, Mylonas A, Patsias A, Roilides E, Giannoulis E, 2008. Long-term evaluation of patients with hydatidosis treated with albendazole and praziquantel. Int J Immunopathol Pharmacol 21: 429435.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    el Hawey AM, Massoud AM, el Rakieby A, Rozeik MS, Nassar MO, 1990. Side effects of praziquantel in bilharzial children on a field level. J Egypt Soc Parasitol 20: 599605.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Jaoko WG, Muchemi G, Oguya FO, 1996. Praziquantel side effects during treatment of Schistosoma mansoni infected pupils in Kibwezi, Kenya. East Afr Med J 73: 499501.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Shen C, Choi MH, Bae YM, Yu G, Wang S, Hong ST, 2007. A case of anaphylactic reaction to praziquantel treatment. Am J Trop Med Hyg 76: 603605.

  • 44.

    Jaoko WG, Muchemi G, Oguya FO, 1996. Praziquantel side effects during treatment of Schistosoma mansoni infected pupils in Kibwezi, Kenya. East Afr Med J 73: 499501.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Alvela-Suarez L, Novo-Veleiro I, Belhassen-Garcia M, Velasco-Tirado V, Jimenez-Cabrera S, Iglesias-Gomez A, Cordero-Sanchez M, 2011. Dysgeusia as an adverse reaction to praziquantel. Drug Chem Toxicol 35: 116117.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Winning A, Braslins P, McCarthy JS, 2009. Case report: nitazoxanide for treatment of refractory bony hydatid disease. Am J Trop Med Hyg 80: 176178.

Past two years Past Year Past 30 Days
Abstract Views 3206 2606 537
Full Text Views 826 14 0
PDF Downloads 443 15 0
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save