From the Guidelines
Albendazole 400 mg orally as a single dose is the recommended treatment for Ascaris lumbricoides infection. This treatment is based on the most recent guidelines from the Journal of Infection, published in 2025 1. The guidelines recommend either albendazole 400 mg, mebendazole 500 mg, or ivermectin 200 μg/kg as a single dose for the treatment of ascariasis.
Key Considerations
- The treatment dose and choice of medication may vary depending on the patient's age, weight, and pregnancy status.
- Alternative treatment options include mebendazole 500 mg or ivermectin 200 μg/kg as a single dose 1.
- It is essential to note that these medications work by either paralyzing the worms or disrupting their cellular metabolism, allowing them to be expelled through normal bowel movements.
Post-Treatment Care
- Patients should be advised that they may see worms in their stool after treatment.
- Follow-up stool examination 2-3 weeks after treatment is recommended to confirm cure.
- Prevention measures include proper handwashing, safe food handling, and improved sanitation to avoid reinfection, as the parasite spreads through ingestion of eggs from contaminated soil or food.
From the FDA Drug Label
The same dosage schedule applies to children and adults. The tablet may be chewed, swallowed, or crushed and mixed with food. Pinworm (enterobiasis)Whipworm (trichuriasis)Common Roundworm (ascariasis)Hookworm Dose1 tablet, once1 tablet morning and evening for 3 consecutive days1 tablet morning and evening for 3 consecutive days1 tablet morning and evening for 3 consecutive days Mebendazole tablets are indicated for the treatment of Enterobius vermicularis (pinworm), Trichuris trichiura (whipworm), Ascaris lumbricoides (common roundworm), Ancylostoma duodenale (common hookworm), Necator americanus (American hookworm) in single or mixed infections.
Treatment for Ascaris lumbricoides:
- The recommended dose is 1 tablet morning and evening for 3 consecutive days.
- If the patient is not cured three weeks after treatment, a second course of treatment is advised 2.
- Mebendazole is indicated for the treatment of Ascaris lumbricoides (common roundworm) 2.
From the Research
Treatment Options for Ascaris Lumbricoides Infection
- The drugs of choice for treating Ascaris lumbricoides infection are albendazole and mebendazole for children and nonpregnant individuals 3.
- Pregnant women with ascariasis should be treated with pyrantel pamoate 3.
- Other anthelminthic alternatives such as tribendimidine and Nitazoxanide have also proved to be safe and effective against A. lumbricoides and other soil-transmitted helminthiases in human trials 4.
- A single dose of albendazole, mebendazole, or ivermectin is effective against Ascaris lumbricoides infection, yielding high parasitological cure and large reductions in eggs excreted 5.
Efficacy of Anthelminthic Drugs
- Albendazole and mebendazole have been found to be highly effective against Ascaris lumbricoides infection, with cure rates of over 96% and egg reduction of over 99.8% 6.
- The average cure rate with anthelminthic treatment is over 95% 3.
- Single-dose of albendazole, mebendazole, and ivermectin all appeared effective against Ascaris lumbricoides infection, with no differences detected between them 5.
Safety of Anthelminthic Drugs
- Albendazole has a remarkable safety record, with a very low incidence of side effects reported in the published literature 7.
- The most commonly reported adverse events were nausea, vomiting, abdominal pain, diarrhoea, headache, and fever 5.
- Anthelminthic drugs appear to be safe to treat children and adults with confirmed Ascaris infection 5.