title: Randomised controlled trial of efficacy of albendazole in intra-abdominal hydatid disease.
abstract: The efficacy of albendazole in hydatid disease is still unclear, because there has been no study that assessed the status of the parasite after treatment. The significance of albendazole-induced echographic changes in the cyst therefore cannot be judged. We did a prospective, controlled, randomised, open study of albendazole in patients with liver hydatid disease, and assessed parasite viability after treatment. 18 patients received no albendazole treatment (controls), 18 received albendazole (10 mg/kg daily) for 1 month (group A), and 19 received the drug for about 3 months (group B). Echography was done before and during treatment; all patients underwent surgery on completion. Parasite (protoscolex viability and development of cysts in mice) and ultrastructure studies were done for all cysts removed. 8 (50%) of cysts in the control group, 13 (72%) in group A, and 16 (94%) in group B were non-viable (p = 0.015). Protoscolex and cyst viability were significantly (p = 0.039 and p = 0.018, respectively) lower in treated patients than in controls. Treatment was also significantly associated with total cyst membrane disintegration. 68% of cysts treated for 3 months showed echographic changes, and only 1 of 20 cysts showing echographic changes during treatment was judged viable. The efficacy of albendazole at a dose of 10 mg/kg daily for 3 months suggests that it is a suitable alternative to surgery in uncomplicated hydatid liver disease, as initial treatment.
authors.affiliation: Department of Gastroenterology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: L A
authors.initials: LA
authors.lastname: Gil-Grande
authors.forename: F
authors.initials: F
authors.lastname: Rodriguez-Caabeiro
authors.forename: J G
authors.initials: JG
authors.lastname: Prieto
authors.forename: J J
authors.initials: JJ
authors.lastname: Sánchez-Ruano
authors.forename: C
authors.initials: C
authors.lastname: Brasa
authors.forename: L
authors.initials: L
authors.lastname: Aguilar
authors.forename: F
authors.initials: F
authors.lastname: García-Hoz
authors.forename: N
authors.initials: N
authors.lastname: Casado
authors.forename: R
authors.initials: R
authors.lastname: Bárcena
authors.forename: A I
authors.initials: AI
authors.lastname: Alvarez
authors.forename: R
authors.initials: R
authors.lastname: Dal-Ré
mesh_terms: D000328:Adult; D015766:Albendazole / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D003131:Combined Modality Therapy; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D004446:Echinococcus / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000469:parasitology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D015766:Albendazole