title: Oxantel pamoate-albendazole for Trichuris trichiura infection.
abstract: BACKGROUND
  Infections with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) are widespread and often occur concomitantly. These parasitic-worm infections are typically treated with albendazole or mebendazole, but both drugs show low efficacy against T. trichiura. Albendazole is the drug of choice against hookworm.
  
  
  METHODS
  In this double-blind trial conducted on Pemba Island, Tanzania, we randomly assigned children, 6 to 14 years of age, to receive one of four treatments: oxantel pamoate at a dose of 20 mg per kilogram of body weight, plus 400 mg of albendazole, administered on consecutive days; oxantel pamoate at a single dose of 20 mg per kilogram; albendazole at a single dose of 400 mg; or mebendazole at a single dose of 500 mg. We assessed the efficacy and safety profile of oxantel pamoate-albendazole when used in the treatment of T. trichiura infection (primary outcome) and concomitant soil-transmitted helminth infection (secondary outcome). Efficacy was determined by means of assessment of the cure rate and egg-reduction rate. Adverse events were assessed four times after treatment.
  
  
  RESULTS
  Complete data were available for 458 children, of whom 450 were infected with T. trichiura, 443 with hookworm, and 293 with A. lumbricoides. The cure rate of T. trichiura infection was significantly higher with oxantel pamoate-albendazole than with mebendazole (31.2% vs. 11.8%, P=0.001), as was the egg-reduction rate (96.0% [95% confidence interval {CI}, 93.5 to 97.6] vs. 75.0% [95% CI, 64.2 to 82.0]). The cure rate with albendazole (2.6%) and the egg-reduction rate with albendazole (45.0%; 95% CI, 32.0 to 56.4) were significantly lower than the rates with mebendazole (P=0.02 for the comparison of cure rates). Oxantel pamoate had low efficacy against hookworm and A. lumbricoides. Adverse events (mainly mild) were reported by 30.9% of all children.
  
  
  CONCLUSIONS
  Treatment with oxantel pamoate-albendazole resulted in higher cure and egg-reduction rates for T. trichiura infection than the rates with standard therapy. (Funded by the Medicor Foundation and the Swiss National Science Foundation; Current Controlled Trials number, ISRCTN54577342.).
authors: From the Departments of Medical Parasitology and Infection Biology (B.S., J.K.) and Epidemiology and Public Health (J. Hattendorf, J.U.), Swiss Tropical and Public Health Institute, and the Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, University of Basel (R.A., J. Huwyler) - all in Basel, Switzerland; the Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania (S.M. Ame, S.M. Ali); and the Ivo de Carneri Foundation, Milan (M.A.).
authors: Benjamin
authors: B
authors: Speich
authors: Shaali M
authors: SM
authors: Ame
authors: Said M
authors: SM
authors: Ali
authors: Rainer
authors: R
authors: Alles
authors: Jörg
authors: J
authors: Huwyler
authors: Jan
authors: J
authors: Hattendorf
authors: Jürg
authors: J
authors: Utzinger
authors: Marco
authors: M
authors: Albonico
authors: Jennifer
authors: J
authors: Keiser
mesh_terms: D000293:Adolescent; D015766:Albendazole / Q000008:administration & dosage* / Q000009:adverse effects; D000818:Animals; D000969:Antinematodal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001196:Ascariasis / Q000188:drug therapy; D017164:Ascaris lumbricoides; D002648:Child; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006725:Hookworm Infections / Q000188:drug therapy; D006801:Humans; D008297:Male; D008463:Mebendazole / Q000008:administration & dosage / Q000009:adverse effects; D011716:Pyrantel Pamoate / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D014257:Trichuriasis / Q000188:drug therapy*; D014258:Trichuris
chemical_list: D000969:Antinematodal Agents; D011716:Pyrantel Pamoate; D008463:Mebendazole; D015766:Albendazole; C037225:oxantel pamoate