title: Treatment Failure after Multiple Courses of Triclabendazole among Patients with Fascioliasis in Cusco, Peru: A Case Series.
abstract: Triclabendazole is reported to be highly effective in treatment of human fascioliasis. We present 7 of 19 selected cases of human fascioliasis referred to our center in the Cusco region of Peru that failed to respond to triclabendazole. These were mostly symptomatic adults of both sexes that continued passing Fasciola eggs in the stool despite multiple treatments with 2 doses of triclabendazole at 10 mg/kg per dose. We documented the presence of eggs by rapid sedimentation and Kato Katz tests after each treatment course. We found that repeated triclabendazole courses were not effective against fascioliasis in this group of people. These findings suggest that resistance to triclabendazole may be an emerging problem in the Andes.
authors.affiliation: Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America.|Sede Cusco-Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Miguel M
authors.initials: MM
authors.lastname: Cabada
authors.affiliation: Sede Cusco-Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Martha
authors.initials: M
authors.lastname: Lopez
authors.affiliation: Hospital Nivel IV Adolfo Guevara Velasco ESSALUD, Cusco, Peru.
authors.forename: Maria
authors.initials: M
authors.lastname: Cruz
authors.affiliation: Sede Cusco-Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Delgado
authors.affiliation: Sede Cusco-Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.|College of Natural Sciences, University of Texas at Austin, Austin, Texas, United States of America.
authors.forename: Virginia
authors.initials: V
authors.lastname: Hill
authors.affiliation: Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America.
authors.forename: A Clinton
authors.initials: AC
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D005210:Fasciola hepatica / Q000187:drug effects / Q000254:growth & development; D005211:Fascioliasis / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D017211:Treatment Failure; D000077682:Triclabendazole
chemical_list: D000871:Anthelmintics; D001562:Benzimidazoles; D000077682:Triclabendazole