Ivermectin: uses and impact 20 years on.
OBJECTIVE
Ivermectin was first discovered and used in veterinary medicine over 20 years ago. This review highlights some of the recent published research from 2005 through June 2006 on the use of ivermectin in both helminth and arthropod infection.


RESULTS
In recent years, several published studies have detailed the expanding role for ivermectin in multiple endo and ectoparasitic infections, including scabies, pediculosis, soil transmitted helminths, gnathostomiasis and myiasis. In addition, there is increasing experience with parenteral ivermectin for the treatment of disseminated strongyloidiasis. The success of ivermectin in reducing Onchocerca volvulus and Wuchereria bancrofti transmission through universal treatment in disease control programs continues to be well documented, but recent epidemiologic data describe suboptimal response to ivermectin by O. volvulus in a minority of individuals, the molecular markers for which are currently under investigation.


CONCLUSIONS
Over 20 years of research and clinical use have advanced ivermectin from its beginnings as a veterinary anthelmintic to its significant role in several successful disease control programs. Nevertheless, further research is needed to understand the basis for suboptimal response and to better define optimal drug regimens for varying diseases.
Fox
Leanne M
LM
Division of Infectious Diseases, Children's Hospital, Boston, Massachusetts 02115, USA. leanne.fox@childrens.harvard.edu
D000818:Animals; D000977:Antiparasitic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004351:Drug Resistance; D004478:Ectoparasitic Infestations / Q000188:drug therapy*; D006373:Helminthiasis / Q000188:drug therapy*; D006801:Humans; D007559:Ivermectin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D017181:Onchocerca volvulus / Q000187:drug effects
D000977:Antiparasitic Agents; D007559:Ivermectin