What is the recommended dose of albendazole (anti-parasitic medication) for a 5-year-old child?

Albendazole Dosing for a 5-Year-Old Child

For a 5-year-old child, administer albendazole 400 mg as a single oral dose for common intestinal parasitic infections (hookworm, ascariasis, pinworm), or 400 mg daily for 3 consecutive days for strongyloidiasis and tapeworm infections. 1, 2

Standard Single-Dose Regimen

• 400 mg single dose is the recommended treatment for children over 24 months with common soil-transmitted helminths including:

  • Hookworm (Necator americanus, Ancylostoma duodenale) 3, 1
  • Ascariasis (Ascaris lumbricoides) 3, 1
  • Enterobiasis/pinworm (Enterobius vermicularis) 1, 4

• This single 400 mg dose achieves excellent cure rates: 100% for Ascaris, 78% overall for hookworm (92% for A. duodenale, 75% for N. americanus), and 98% for pinworm 4

Extended Multi-Day Regimens

For specific parasitic infections requiring longer treatment courses:

• Strongyloidiasis: 400 mg once daily for 3 consecutive days achieves an 81% cure rate 5

  • Consider repeating the 3-day course one week later to increase cure rate to 92% 5

• Taenia species (tapeworm): 400 mg once daily for 3 days 1, 2

• Visceral larva migrans (Toxocara): 400 mg twice daily for 5 days 2

• Capillariasis: 400 mg twice daily for 21 days with monitoring of liver function and blood counts 2

Empirical Treatment Considerations

• For asymptomatic eosinophilia with negative stool studies, consider empirical treatment with albendazole 400 mg single dose plus ivermectin 200 μg/kg to cover prepatent geohelminth infections 3

• Repeat treatment at 8 weeks may be necessary for schistosomiasis or other helminth infections where eggs and immature forms are resistant to initial treatment 3, 2

Administration and Safety

• Albendazole can be given with or without food, though absorption improves with fatty meals for extended courses 6

• For treatment courses exceeding 14 days, monitor for hepatotoxicity and leukopenia 6, 2

• Side effects are rare (gastrointestinal symptoms occur in just over 1% of patients) and typically mild and transient 4, 5

Common Pitfalls to Avoid

• Trichuris trichiura (whipworm) responds poorly to single-dose albendazole (cure rate only 48%) 4

  • Consider alternative regimens or combination therapy for whipworm infections 2

• Do not use ivermectin in combination regimens without first excluding Loa loa in children who have traveled to endemic regions 3

• For children aged 12-24 months, expert consultation is required before administering albendazole 3, 1, 2