From the Guidelines
Intestinal worms require prompt treatment with antiparasitic medications, such as albendazole or mebendazole, to prevent complications and improve quality of life. The primary diagnostic method for intestinal worms is stool microscopy examination, which may require multiple samples collected on different days to increase detection rates 1. Blood tests may also show eosinophilia (elevated eosinophil count) in some helminth infections.
Treatment Options
- For common roundworms like Ascaris, hookworms, and pinworms, albendazole (400mg as a single dose for most adults) is effective 1.
- Mebendazole (500 mg) is an alternative option for treating earthworm-sized intestinal worms 1.
- For tapeworm infections, such as Taenia saginata or T. solium, praziquantel (10 mg/kg as a single dose) is typically used 1.
Prevention and Management
Good hygiene practices are essential to prevent reinfection, including:
- Handwashing
- Proper food preparation
- Wearing shoes in endemic areas
- Washing bedding regularly Treatment should include all household members for highly contagious infections like pinworms. Follow-up stool examination may be necessary to confirm clearance of the infection. These medications work by either paralyzing the worms or disrupting their metabolic processes, allowing the body to eliminate them naturally. Most treatments are highly effective with minimal side effects.
From the FDA Drug Label
Mebendazole tablets are indicated for the treatment of Enterobius vermicularis (pinworm), Trichuris trichiura (whipworm), Ascaris lumbricoides (common roundworm), Ancylostoma duodenale (common hookworm), Necator americanus (American hookworm) in single or mixed infections. Efficacy rates derived from various studies are shown in the table below: Pinworm (enterobiasis)Whipworm (trichuriasis)Common Roundworm (ascariasis)Hookworm Cure rates mean95%68%98%96% Egg reduction mean—93%99%99% Ivermectin is active against various life-cycle stages of many but not all nematodes. It is active against the tissue microfilariae of Onchocerca volvulus but not against the adult form. Its activity against Strongyloides stercoralis is limited to the intestinal stages
Investigations and Treatment for Intestinal Worms:
- Mebendazole is used to treat Enterobius vermicularis (pinworm), Trichuris trichiura (whipworm), Ascaris lumbricoides (common roundworm), Ancylostoma duodenale (common hookworm), and Necator americanus (American hookworm) with cure rates of 95%, 68%, 98%, and 96% respectively 2.
- Ivermectin is active against various life-cycle stages of many nematodes, including Strongyloides stercoralis (limited to intestinal stages) and Onchocerca volvulus (tissue microfilariae) 3.
- Diagnosis of intestinal worms typically involves stool examinations, which may require concentration techniques such as using a Baermann apparatus 3.
- Treatment with mebendazole or ivermectin should be based on the specific type of intestinal worm infection and the patient's condition, with follow-up stool examinations to ensure eradication 2, 3.
From the Research
Intestinal Worms Investigations
- Intestinal worms can be diagnosed through various methods, including stool tests and physical examinations 4, 5, 6
- The diagnosis of intestinal worms is crucial in determining the appropriate treatment approach 5, 6
Treatment Options
- Albendazole and mebendazole are commonly used to treat intestinal nematode infections, including ascariasis, hookworm infections, trichuriasis, strongyloidiasis, and enterobiasis 4, 6
- Ivermectin is also effective against Strongyloides stercoralis and can be used in combination with albendazole for whipworm infections 5, 6
- Praziquantel is effective against most nematodes and trematodes, including intestinal tapeworm infections 5, 6
- Combination therapy with albendazole and oxantel pamoate has shown high efficacy against Trichuris trichiura infections 7
Treatment Considerations
- The choice of treatment depends on the type of intestinal worm infection, as well as the severity of the infection 4, 5, 6
- Mass treatment of children in areas with high prevalence of intestinal nematode infections can be an effective strategy for control and prevention 8
- The cost-effectiveness of treatment options should also be considered, with albendazole and ivermectin being relatively inexpensive and effective options 8
Efficacy and Safety
- Albendazole and mebendazole are generally safe and well-tolerated, but can cause side effects such as liver toxicity and neutropenia 4, 6
- Ivermectin and praziquantel are also generally safe, but can cause side effects such as abdominal cramps and headaches 5, 6, 7
- Combination therapy with albendazole and oxantel pamoate has shown a good safety profile, with mainly mild adverse events reported 7