Evaluation of Oxfendazole, Praziquantel and Albendazole against Cystic Echinococcosis: A Randomized Clinical Trial in Naturally Infected Sheep

Autor: Eduardo A. Barron, Monica Llamosas, Armando E. Gonzalez, Robert H. Gilman, Cesar M. Gavidia, Manuela Verastegui, Berenice Ninaquispe, Colin L Robinson
Jazyk: angličtina
Rok vydání: 2010
Předmět:
medicine.medical_treatment
Gastroenterology
Praziquantel
0302 clinical medicine
Medicine
Echinococcus granulosus
2. Zero hunger
Anthelmintics
0303 health sciences
biology
lcsh:Public aspects of medicine
Combination chemotherapy
Echinococcosis
3. Good health
Pharmacology/Drug Interactions
Infectious Diseases
Treatment Outcome
Drug Therapy
Combination
medicine.drug
Research Article
Infectious Diseases/Epidemiology and Control of Infectious Diseases
medicine.medical_specialty
lcsh:Arctic medicine. Tropical medicine
Oxfendazole
lcsh:RC955-962
030231 tropical medicine
Public Health and Epidemiology
Sheep Diseases
Placebo
Albendazole
03 medical and health sciences
Internal medicine
parasitic diseases
Animals
Chemotherapy
030306 microbiology
business.industry
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
biology.organism_classification
medicine.disease
Survival Analysis
Surgery
Infectious Diseases/Neglected Tropical Diseases
Benzimidazoles
business
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 4, Iss 2, p e616 (2010)
ISSN: 1935-2735
1935-2727
Popis: Background Cystic Echinococosis (CE) is a zoonotic disease caused by larval stage Echinococcus granulosus. We determined the effects of high dose of Oxfendazole (OXF), combination Oxfendazole/Praziquantel (PZQ), and combination Albendazole (ABZ)/Praziquantel against CE in sheep. Methodology/Principal Findings A randomized placebo-controlled trial was carried out on 118 randomly selected ewes. They were randomly assigned to one of the following groups: 1) placebo; 2) OXF 60 mg/Kg of body weight (BW) weekly for four weeks; 3) ABZ 30 mg/Kg BW + PZQ 40 mg/Kg BW weekly for 6 weeks, and 4) OXF 30 mg/Kg BW+ PZQ 40 mg/Kg BW biweekly for 3 administrations (6 weeks). Percent protoscolex (PSC) viability was evaluated using a 0.1% aqueous eosin vital stain for each cyst. “Noninfective” sheep were those that had no viable PSCs; “low-medium infective” were those that had 1% to 60% PSC viability; and “high infective” were those with more than 60% PSC viability. We evaluated 92 of the 118 sheep. ABZ/PZQ led the lowest PSC viability for lung cysts (12.7%), while OXF/PZQ did so for liver cysts (13.5%). The percentage of either “noninfective” or “low-medium infective” sheep was 90%, 93.8% and 88.9% for OXF, ABZ/PZQ and OXF/PZQ group as compared to 50% “noninfective” or “low-medium infective” for placebo. After performing all necropsies, CE prevalence in the flock of sheep was 95.7% (88/92) with a total number of 1094 cysts (12.4 cysts/animal). On average, the two-drug-combination groups resulted pulmonary cysts that were 6 mm smaller and hepatic cysts that were 4.2 mm smaller than placebo (p
Author Summary Cystic Echinococcosis (CE) is a near-cosmopolitan parasitic zoonosis that causes economic losses in many regions of the world. This parasitic infection can be regarded as an emerging or re-emerging disease causing considerable losses in livestock production. CE is produced by the larval cystic stage (hydatid) of the dog parasite Echinococcus granulosus. After infective eggs are ingested, cysts develop mainly in lungs and liver of humans and animals (sheep, cattle, pigs, horses, etc). Infected people may require surgery and/or Albendazole-based chemotherapy. In this study, we evaluated the effects of Oxfendazole alone (an antiparasitic drug used in animals), Oxfendazole plus Praziquantel, and Albendazole plus Praziquantel against hydatid cysts in sheep over 4 to 6 weeks of treatment. All of the treatments in this study were efficacious in killing the larval stages and, therefore, in minimizing the risk of a dog acquiring new infections (taenias). These treatment schemes can be added to control measures in animals and eventually could be used for the treatment of human infection. Further investigations on different schedules of monotherapy or combined chemotherapy are needed, as well as studies to evaluate the safety and efficacy of Oxfendazole in humans.
Databáze: OpenAIRE
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