Treatment of Roundworm (Ascaris lumbricoides) Infection
The recommended treatment for roundworm infection is albendazole 400 mg orally as a single dose, with a repeat dose in 2 weeks. 1, 2
First-Line Treatment
- Albendazole 400 mg orally as a single dose is the treatment of choice, with excellent cure rates of 96-100% for Ascaris lumbricoides infection 3, 4
- A repeat dose should be given in 2 weeks to eradicate any newly hatched worms and ensure complete clearance 1
- The same dosing regimen applies to both adults and children of all ages 1, 5
Alternative Treatment Option
- Mebendazole 100 mg orally twice daily (morning and evening) for 3 consecutive days is an equally effective alternative 2
- Mebendazole achieves a 98% cure rate for common roundworm infection 2
- The tablet may be chewed, swallowed, or crushed and mixed with food 2
Clinical Presentation to Recognize
- Roundworm infection may present with nausea, vomiting, diarrhea, and abdominal pain 1
- Heavy infections can cause intestinal obstruction or migration to bile ducts 1
- Many patients remain asymptomatic despite significant worm burden 1
Diagnostic Approach
- Diagnosis is made through concentrated stool microscopy or fecal PCR 1
- Multiple stool samples may be needed due to intermittent egg shedding 1
- No special procedures such as fasting or purging are required before treatment 2
Monitoring and Follow-Up
- If albendazole is used for more than 14 days (not typical for simple roundworm), monitor for hepatotoxicity and leukopenia 1
- If symptoms persist after treatment, repeat stool examination 2-3 weeks post-treatment 1
- Treatment failure is rare; persistent symptoms usually indicate reinfection rather than drug resistance 5
Prevention of Reinfection
- Hand hygiene and proper sanitation are essential preventive measures 1
- Consider screening and treating household contacts in endemic settings 1
- Wearing shoes and avoiding contact with contaminated soil reduces transmission risk 1