Macrofilaricidal effect of 4 weeks of treatment with doxycycline on Wuchereria bancrofti.
OBJECTIVE
To evaluate the efficacy of doxycycline as a macrofilaricidal agent against Wuchereria bancrofti.


METHODS
In the Western Region of Ghana, 18 patients infected with W. bancrofti were recruited and treated with 200 mg doxycycline per day for 4 weeks. Seven untreated patients served as controls. Four months after doxycycline treatment, all patients received 150 mug/kg ivermectin. Patients were monitored for Wolbachia and microfilaria loads, antigenaemia and filarial dance sign (FDS).


RESULTS
Four months after doxycycline treatment, cases had a significantly lower Wolbachia load than controls; and 24 months after treatment, microfilaraemia, antigenaemia and frequency of FDS were significantly lower in cases than controls. Most importantly, 4 weeks of doxycycline killed 80% of macrofilariae, which is comparable with the results of a 6-week regimen. Circulating filarial antigenaemia and FDS were strongly correlated.


CONCLUSIONS
A 4-week regimen of doxycycline seems sufficient to kill adult W. bancrofti and could be advantageous for the treatment of individual patients, e.g. in outpatient clinics.
Debrah
Alexander Yaw
AY
Institute for Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany.
Mand
Sabine
S
Marfo-Debrekyei
Yeboah
Y
Batsa
Linda
L
Pfarr
Kenneth
K
Buttner
Marcelle
M
Adjei
Ohene
O
Buttner
Dietrich
D
Hoerauf
Achim
A
D000293:Adolescent; D000328:Adult; D000818:Animals; D000947:Antigens, Helminth / Q000097:blood; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use*; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000276:immunology; D005869:Ghana; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014958:Wuchereria bancrofti / Q000187:drug effects* / Q000302:isolation & purification / Q000472:pathogenicity
D000947:Antigens, Helminth; D000977:Antiparasitic Agents; D007559:Ivermectin; D004318:Doxycycline