What is the treatment for Taenia (tapeworm) infestation?

From the Guidelines

To treat tapeworm infections, a single dose of niclosamide 2g PO or praziquantel 10 mg/kg PO is recommended, depending on the species of tapeworm, with the choice of medication guided by the need to exclude concomitant neurocysticercosis in cases of T. solium infection. When the causative Taenia species is uncertain, a single dose of niclosamide 2g PO is suggested 1. For T. solium, a single dose of niclosamide 2g PO is recommended to clear the intestinal infection, while praziquantel 10 mg/kg PO should not be used unless concomitant neurocysticercosis has been excluded 1. In the case of T. saginata, praziquantel 10 mg/kg PO as a single dose is suggested, with niclosamide 2g PO as an alternative 1. It is essential to identify the specific tapeworm species through stool samples or imaging tests to determine the appropriate medication and dosage, and follow-up stool tests are crucial to confirm the infection is cleared 1. Prevention of tapeworm infections includes thoroughly cooking meat, practicing good hygiene, and proper handwashing, as tapeworms are contracted by consuming undercooked meat containing larvae or through fecal-oral contamination 1. Key considerations in the treatment of tapeworm infections include:

• The need to exclude concomitant neurocysticercosis in cases of T. solium infection
• The choice of medication based on the species of tapeworm
• The importance of follow-up stool tests to confirm the infection is cleared
• The role of prevention in reducing the risk of tapeworm infections.

From the FDA Drug Label

1.1 Neurocysticercosis Albendazole tablets are indicated for the treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of the pork tapeworm, Taenia solium. 1.2 Hydatid Disease Albendazole tablets are indicated for the treatment of cystic hydatid disease of the liver, lung, and peritoneum, caused by the larval form of the dog tapeworm, Echinococcus granulosus.

Albendazole is used for the treatment of tapeworm infections, specifically:

• Neurocysticercosis caused by the larval form of the pork tapeworm (Taenia solium).
• Hydatid disease caused by the larval form of the dog tapeworm (Echinococcus granulosus). The dosage of albendazole varies depending on the indication and patient weight, as outlined in the dosage and administration section of the label 2.

From the Research

Tape Worm Treatment Options

• The treatment of tapeworm infections can be achieved through the use of various anthelmintic drugs, including niclosamide, praziquantel, and nitazoxanide 3, 4, 5.
• Nitazoxanide has been shown to be effective in treating niclosamide- and praziquantel-resistant beef tapeworm infection, with a cure rate of 98.1% 3.
• Praziquantel is effective against most nematodes and trematodes, with cure rates ranging from 75% to 85% for tapeworm infections 6.
• Albendazole, ivermectin, and nitazoxanide appear to be effective for Ascaris infections, with cure rates of 88%, 100%, and 91%, respectively 6.

Drug Efficacy and Safety

• The efficacy and safety of different drugs for preventive chemotherapy of Taenia solium taeniasis have been assessed in a systematic review, which found that praziquantel 10mg/kg, albendazole 400mg per day for three consecutive days, or niclosamide 2g resulted in better cure rates than praziquantel 5mg/kg or single dose albendazole 400mg 5.
• Most studies reported either no or only mild and transient side-effects within the first three days following drug administration for all drugs and doses 5.
• Nitazoxanide has been shown to be a safe, effective, inexpensive, and well-tolerated drug for the treatment of niclosamide- and praziquantel-resistant beef tapeworm infection, with mild side effects occurring in only 7 patients 3.

Treatment Considerations

• The choice of treatment for tapeworm infections depends on the type of infection, the severity of symptoms, and the patient's medical history 4, 6.
• Combination therapy with ivermectin and albendazole may be effective for whipworm infections, with cure rates ranging from 38% to 80% 6.
• Praziquantel is effective for intestinal trematode infections, with cure rates of 97% to 100% 6.