Solitary cysticercus granuloma-treatment with albendazole: what is the optimal duration?

摘要

The era of antihelminthic treatment in neurocysticercosis (NCC) began in 1978 with the first use of praziquantel. Later in 1987, albendazole was introduced in the treatment of NCC. Treatment with albendazole for 1 month in 7 patients, who also served as historical controls, resulted in reduction of the cyst load by 25 % at 1 month; and by another 14%, at 3 months. Albendazole was found to be as effective as praziquantel, but more economical and convenient to administer. Initially, the dose and duration of albendazole (15 mg/kg/d for 30 days) in NCC was based on the experience of a related parasitic disorder, human echinococcosis. Subsequent small controlled and uncontrolled trials have shown that shorter duration of treatment (15 days and 7 days) results in reduced active cyst burden by 3% to 25% at 3 months. A randomized, double-blind trial of albendazole, 7 versus 14 days, found no difference in the efficacy as measuredby the reduction in cyst load on computed tomography (CT) at 3 months after intervention. Subsequent to this study, 1 week of treatment has been purported to be effective, well tolerated and cost effective and the preferred duration of treatment in active parenchymal NCC (multiple lesions).