What is the recommended dosage of albendazole (anthelmintic medication) for pediatric patients with parasitic infections?

Albendazole Dosing for Pediatric Parasitic Infections

The recommended dosage of albendazole for pediatric patients with parasitic infections is 400 mg as a single dose for children ≥2 years weighing ≥60 kg, and 15 mg/kg/day (maximum 800 mg daily) divided into two doses for children weighing <60 kg, with duration varying by parasite type. 1, 2

Dosage Guidelines by Parasite Type

Intestinal Nematodes (Roundworms)

• Hookworm (Ancylostoma duodenale and Necator americanus)

  • 400 mg daily for 3 days 1
  • For children <60 kg: 15 mg/kg/day divided into two doses (maximum 800 mg daily) 2
  • Cure rates: 87.2% for A. duodenale, 75% for N. americanus 3

• Ascariasis (Ascaris lumbricoides)

  • Single dose of 400 mg or 15 mg/kg for children <60 kg 1, 2
  • Highly effective with cure rates of 91.9-95% 3, 4

• Threadworm (Enterobius vermicularis)

  • Single dose of 400 mg 3
  • Repeat after 2 weeks if reinfection suspected
  • Cure rate: 98% 3

Intestinal Cestodes (Tapeworms)

• Hymenolepis nana

  • 400 mg daily for 3 days 4
  • For children <60 kg: 15 mg/kg/day divided into two doses (maximum 800 mg daily) 2
  • Cure rate: 68-71.4% 3, 4

• Taenia species

  • 400 mg daily for 3 days 3
  • For children <60 kg: 15 mg/kg/day divided into two doses (maximum 800 mg daily) 2
  • Cure rate: 85% 3

Tissue Parasites

• Neurocysticercosis (Taenia solium larvae)

  • For children ≥60 kg: 400 mg twice daily with meals
  • For children <60 kg: 15 mg/kg/day divided into two doses (maximum 800 mg daily)
  • Duration: 8-30 days 2
  • Concurrent steroid and anticonvulsant therapy recommended to prevent neurological symptoms 1, 2

• Hydatid Disease (Echinococcus granulosus larvae)

  • For children ≥60 kg: 400 mg twice daily with meals
  • For children <60 kg: 15 mg/kg/day divided into two doses (maximum 800 mg daily)
  • Duration: 28-day cycles followed by 14-day albendazole-free intervals, for a total of 3 cycles 2

Administration Guidelines

• Administer with food to improve absorption 2
• Tablets may be crushed or chewed and swallowed with water 2
• For young children who cannot swallow tablets, a suspension can be used

Monitoring During Treatment

• Monitor blood counts at the beginning of each 28-day cycle and every 2 weeks during therapy 1, 2
• Monitor liver enzymes (transaminases) at the beginning of each 28-day cycle and at least every 2 weeks during treatment 1, 2
• Discontinue if clinically significant decreases in blood cell counts occur 2

Safety Considerations

• Albendazole has a remarkable safety record with over several hundred million patient exposures 3
• Side effects are generally mild and infrequent, with gastrointestinal side effects occurring at a frequency just >1% 3
• Contraindicated in patients with known hypersensitivity to benzimidazole compounds 2
• Use with caution in patients with liver disease due to increased risk of bone marrow suppression 2
• Pregnancy testing recommended for females of reproductive potential prior to therapy 2

Treatment Efficacy Considerations

• Efficacy varies by parasite species and infection intensity
• For Trichuris trichiura (whipworm), albendazole is less effective as a single dose (cure rates <30%) and requires 3-5 days of treatment for better efficacy 5
• For mixed infections, dosing should be based on the parasite requiring the longest treatment duration

Albendazole's broad-spectrum activity and excellent safety profile make it suitable for both individual treatment and mass deworming programs in children, contributing to improved nutrition and development 3.