Albendazole Dosing for Prophylaxis in a 6-Year-Old, 20kg Child
For prophylaxis against soil-transmitted helminths in a 6-year-old child weighing 20kg, administer albendazole 400 mg as a single oral dose.
Standard Prophylactic Dosing
The FDA-approved dose for children weighing less than 60 kg is 15 mg/kg/day in divided doses twice daily (maximum 800 mg/day total) for treatment of systemic infections like hydatid disease or neurocysticercosis 1
However, for prophylaxis against soil-transmitted helminths (Ascaris, hookworm, Trichuris), the standard single-dose regimen is 400 mg regardless of weight for children over 12 months of age 2, 3, 4
For this 20kg child, the weight-based calculation (15 mg/kg) would yield 300 mg, but the standard prophylactic dose remains 400 mg as a single dose, which has been extensively validated in pediatric populations 3, 4, 5
Evidence Supporting Single 400mg Dose
Multi-country trials in school children demonstrated that a single 400 mg dose of albendazole achieves cure rates of 98.2% for Ascaris and 87.8% for hookworms, with fecal egg count reductions of 99.5% and 94.8% respectively 3
Studies in children as young as 8-24 months using 200 mg doses showed excellent efficacy, and the 400 mg dose is well-established for children over 2 years 5
Albendazole has been safely used in children as young as 12 months when local circumstances justify treatment for ascariasis and trichuriasis 2
Administration Guidelines
Albendazole tablets should be taken with food to enhance absorption 1
For prophylaxis in endemic areas, this single 400 mg dose is typically repeated every 6-12 months as part of mass drug administration programs 3
Important Caveats
For Trichuris trichiura specifically, efficacy is lower (46.6% cure rate, 50.8% egg reduction) with single-dose therapy, and higher doses (600 mg) or repeated dosing may be needed for treatment rather than prophylaxis 3, 4
The 400 mg single dose is for prophylaxis/treatment of intestinal helminths only; systemic infections require different dosing regimens (15 mg/kg/day divided twice daily for 8-30 days) 1
Benzimidazoles have the same safety profile in young children as in older children, with minimal side effects reported 2, 5