From the Guidelines
The recommended treatment for schistosomiasis is praziquantel, with a dosage of 40 mg/kg as a single dose for S. mansoni, S. intercalatum, and S. guineensis infections, and 60 mg/kg in two divided doses for S. japonicum and S. mekongi infections. This treatment is based on the most recent and highest quality study available, which was published in 2025 1. The study provides guidelines for the investigation and management of eosinophilia in returning travelers and migrants, including those infected with schistosomiasis.
Key Considerations
- The dosage of praziquantel varies depending on the species of Schistosoma, with S. mansoni, S. intercalatum, and S. guineensis requiring 40 mg/kg and S. japonicum and S. mekongi requiring 60 mg/kg 1.
- Praziquantel should be taken with food and water to improve absorption and reduce gastrointestinal side effects.
- Treatment is highly effective, with cure rates of 70-90% after a single treatment course.
- Side effects are generally mild and transient, including abdominal pain, dizziness, headache, and nausea.
Additional Supportive Care
- In areas with high reinfection rates, preventive treatment may need to be repeated annually.
- For severe complications of schistosomiasis, additional supportive care and management of specific symptoms may be necessary.
- Early treatment is important to prevent chronic complications such as liver fibrosis, bladder cancer, or urinary tract obstruction.
Previous Studies
- Previous studies, such as those published in 2010 1 and 2009 1, also recommend praziquantel as the treatment of choice for schistosomiasis, but the 2025 study provides the most up-to-date and comprehensive guidelines.
From the FDA Drug Label
The presence of parasites should be confirmed by laboratory fecal examination. Weigh the animal before treatment. Administer the proper dosage as specified in the following table as a single oral treatment.
The recommended treatment for schistosomiasis is not explicitly mentioned in the provided drug label.
- Key points:
- The drug label discusses the treatment of various parasites, including tapeworms, but does not directly address schistosomiasis.
- The label provides dosage information for Drontal Plus Taste Tabs Tablets, but this is for the treatment of parasites such as Dipylidium caninum and Echinococcus multilocularis, not schistosomiasis.
- Praziquantel is the active ingredient in the drug, but its use for schistosomiasis is not directly mentioned in the label 2.
From the Research
Schistosoma Treatment
The recommended treatment for schistosomiasis is primarily based on chemotherapy, with praziquantel being the most widely used drug due to its high efficacy, excellent tolerability, and competitive cost 3, 4, 5.
Praziquantel Treatment
- Praziquantel is usually administered in a single oral dose and has no or only mild and transient side effects 3.
- It is highly efficacious against all three main species of Schistosoma (S. japonicum, S. mansoni, and S. haematobium) 3, 6.
- However, the emergence of resistance to praziquantel has been a concern, with reduced susceptibility observed in some field isolates and cases of treatment failure 4.
Alternative and Combination Therapies
- Oxamniquine derivatives have shown promise in overcoming some of the limitations of praziquantel, including the ability to kill immature stages of the parasite and potential use in combination therapy 7.
- Other drugs such as metrifonate and oxamniquine have been used in the past, but they are limited by their narrow spectrum of activity and variable efficacy and safety profiles 6.
Future Directions
- Further research is needed to understand the mechanisms of praziquantel resistance and to develop new, effective treatments for schistosomiasis 4, 5.
- Combination therapies, such as the use of praziquantel with oxamniquine derivatives, may offer a way to overcome resistance and improve treatment outcomes 7.