Drug Combinations Against Soil-Transmitted Helminth Infections.

Authors:
Wendelin Moser
Wendelin Moser
Swiss Tropical and Public Health Institute
Christian Schindler
Christian Schindler
Swiss Tropical and Public Health Institute
Switzerland
Jennifer Keiser
Jennifer Keiser
Swiss Tropical and Public Health Institute
Switzerland

Adv Parasitol 2019 7;103:91-115. Epub 2018 Sep 7.

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

The soil-transmitted helminths (STHs), Ascaris lumbricoides, hookworm and Trichuris trichiura are common in areas with warm and moist climates with little access to adequate water, sanitation, and hygiene affecting the poorest populations. The current control strategy of the World Health Organization is preventive chemotherapy (PC), i.e., the administration of the two benzimidazoles (albendazole and mebendazole) using single, oral doses to at risk populations without prior diagnosis. The recent success of PC is threatened by anthelmintic drug resistance and the low efficacy of the drugs against hookworm (mebendazole) and T. trichiura (albendazole and mebendazole). Only a handful of alternative drugs with anthelmintic properties are available, however, none of the drugs show high efficacy against all three STHs. The combination of two drugs with different activity profiles presents an attractive alternative, which could prevent the development of drug resistance and increase the efficacy compared to monotherapy. In this review, we summarize the efficacy of current and alternative anthelmintics, coadministrations and triple drug therapies assessed by means of network meta-analysis including only randomized controlled trials. Our results highlight that coadministrations have improved efficacy over monotherapy and the necessity of adapting current STH control strategies for the successful continuation of PC programs.

Download full-text PDF

Source
http://dx.doi.org/10.1016/bs.apar.2018.08.002DOI Listing
September 2018
1 Read

Publication Analysis

Top Keywords

drug resistance
8
albendazole mebendazole
8
efficacy
5
high efficacy
4
handful alternative
4
drugs high
4
properties drugs
4
drugs anthelmintic
4
anthelmintic properties
4
efficacy three
4
alternative drugs
4
three sths
4
profiles presents
4
presents attractive
4
attractive alternative
4
activity profiles
4
drugs activity
4
sths combination
4
combination drugs
4
mebendazole handful
4

Similar Publications