title: Efficacy of single-dose and triple-dose albendazole and mebendazole against soil-transmitted helminths and Taenia spp.: a randomized controlled trial.
abstract: BACKGROUND
  The control of soil-transmitted helminth (STH) infections currently relies on the large-scale administration of single-dose oral albendazole or mebendazole. However, these treatment regimens have limited efficacy against hookworm and Trichuris trichiura in terms of cure rates (CR), whereas fecal egg reduction rates (ERR) are generally high for all common STH species. We compared the efficacy of single-dose versus triple-dose treatment against hookworm and other STHs in a community-based randomized controlled trial in the People's Republic of China.
  
  
  RESULTS
  The hookworm CR and fecal ERR were assessed in 314 individuals aged ≥5 years who submitted two stool samples before and 3-4 weeks after administration of single-dose oral albendazole (400 mg) or mebendazole (500 mg) or triple-dose albendazole (3×400 mg over 3 consecutive days) or mebendazole (3×500 mg over 3 consecutive days). Efficacy against T. trichiura, Ascaris lumbricoides, and Taenia spp. was also assessed. ALBENDAZOLE CURED SIGNIFICANTLY MORE HOOKWORM INFECTIONS THAN MEBENDAZOLE IN BOTH TREATMENT REGIMENS (SINGLE DOSE: respective CRs 69% (95% confidence interval [CI]: 55-81%) and 29% (95% CI: 20-45%); triple dose: respective CRs 92% (95% CI: 81-98%) and 54% (95% CI: 46-71%)). ERRs followed the same pattern (single dose: 97% versus 84%; triple dose: 99.7% versus 96%). Triple-dose regimens outperformed single doses against T. trichiura; three doses of mebendazole - the most efficacious treatment tested - cured 71% (95% CI: 57-82%). Both single and triple doses of either drug were highly efficacious against A. lumbricoides (CR: 93-97%; ERR: all >99.9%). Triple dose regimens cured all Taenia spp. infections, whereas single dose applications cured only half of them.
  
  
  CONCLUSIONS
  Single-dose oral albendazole is more efficacious against hookworm than mebendazole. To achieve high CRs against both hookworm and T. trichiura, triple-dose regimens are warranted.
  
  
  BACKGROUND
  www.controlled-trials.com ISRCTN47375023.
authors: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. peter.steinmann@unibas.ch
authors: Peter
authors: P
authors: Steinmann
authors: Jürg
authors: J
authors: Utzinger
authors: Zun-Wei
authors: ZW
authors: Du
authors: Jin-Yong
authors: JY
authors: Jiang
authors: Jia-Xu
authors: JX
authors: Chen
authors: Jan
authors: J
authors: Hattendorf
authors: Hui
authors: H
authors: Zhou
authors: Xiao-Nong
authors: XN
authors: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002681:China; D004334:Drug Administration Schedule; D005260:Female; D006373:Helminthiasis / Q000188:drug therapy*; D006376:Helminths / Q000187:drug effects* / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008463:Mebendazole / Q000627:therapeutic use*; D012987:Soil / Q000469:parasitology; D013621:Taenia / Q000187:drug effects* / Q000472:pathogenicity*; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D012987:Soil; D008463:Mebendazole; D015766:Albendazole