Mechanism of Action: How Albendazole Kills Hookworm
Albendazole kills hookworms by binding to β-tubulin proteins in the parasite's cells, preventing microtubule formation and ultimately causing parasite death through energy depletion. 1
Molecular Mechanism
Albendazole specifically binds to the colchicine-sensitive site of β-tubulin, inhibiting polymerization into microtubules. 1 This binding disrupts the parasite's cellular architecture and function through the following cascade:
The decrease in microtubules in the intestinal cells of hookworms impairs their absorptive function, particularly blocking glucose uptake by both adult and larval forms. 1
Reduced glucose absorption depletes the parasite's glycogen storage reserves. 1
Insufficient glucose results in inadequate energy production, specifically preventing synthesis of adenosine triphosphate (ATP). 1
Without sufficient ATP, the parasite eventually dies. 1
Additional Ovicidal Effects
Beyond killing adult worms, albendazole demonstrates ovicidal activity against hookworm eggs, preventing their development into infective larvae. 2 This dual action against both adult parasites and eggs contributes to its high efficacy in treating hookworm infections.
Clinical Efficacy Against Hookworm Species
The mechanism translates to differential clinical outcomes depending on hookworm species:
For Ancylostoma duodenale infections, albendazole achieves a 92% cure rate with the standard 400 mg single dose. 3
For Necator americanus infections, the cure rate is 75% with the same single 400 mg dose. 3
Overall hookworm cure rates across both species average 78%, with egg reduction rates of approximately 95%. 3, 4
Resistance Mechanism
Parasitic resistance to albendazole occurs when amino acid changes alter the β-tubulin protein structure, reducing drug binding affinity. 1 This is an important consideration in areas with repeated mass drug administration, though resistance remains relatively uncommon in hookworm populations compared to other helminths.