Albendazole 400 mg for a 4-Year-Old Child
For a 4-year-old child, albendazole 400 mg is the appropriate and recommended dose for treating common parasitic infections. 1, 2
Standard Dosing for Children Over 24 Months
A single dose of 400 mg albendazole is recommended for children over 24 months (2 years) of age for most common helminth infections including hookworm, ascariasis, and enterobiasis. 3, 1 Since your patient is 4 years old, they fall well within this age range and can safely receive the full 400 mg dose.
Dosing by Specific Infection Type
The duration and frequency of albendazole 400 mg varies depending on the parasitic infection:
Single-Dose Regimens
- Ascariasis (roundworm): 400 mg single dose achieves 100% cure rates 4
- Hookworm: 400 mg single dose is highly effective 3, 4
- Enterobiasis (pinworm): 400 mg single dose, with repeat dosing in 2 weeks recommended 3
- Empirical treatment for asymptomatic eosinophilia: 400 mg single dose plus ivermectin 200 μg/kg 3
Multi-Day Regimens
- Strongyloidiasis: 400 mg daily for 3 days 3
- Trichuriasis (whipworm): Albendazole alone has poor cure rates (27-60%); combination therapy with mebendazole and ivermectin is preferred 2
- Capillariasis: 400 mg twice daily for 21 days with liver function and blood count monitoring 3, 2
- Visceral larva migrans (Toxocara): 400 mg twice daily for 5 days 2
- Giardiasis: 400 mg daily for 5 days achieves 95% cure rate 5
Important Clinical Considerations
Monitoring Requirements
- For treatment courses exceeding 14 days, monitor liver function tests and complete blood counts to detect potential hepatotoxicity and leukopenia 1, 2
Repeat Dosing
- For certain helminth infections where eggs and immature stages are resistant to treatment, repeat the dose at 8 weeks to treat residual worms that have matured into adults 3
Common Pitfalls
- Single-dose albendazole has limited effectiveness against Trichuris trichiura (whipworm), with only 27-60% cure rates and approximately 50% egg reduction 2, 6. Do not rely on single-dose therapy for whipworm infections.
- Reinfection rates are high in endemic areas. Studies show Ascaris infections return to baseline levels by 12-16 weeks post-treatment without environmental interventions 7
Special Precautions
- Before administering ivermectin (often given with albendazole for empirical treatment), exclude Loa loa infection in children who have traveled to endemic regions in Central/West Africa 3
- For children aged 12-24 months, expert consultation is required before administering albendazole, as safety and efficacy data are limited in this younger age group 1, 2
Administration
Albendazole can be given as a single dose without regard to meals, though absorption is enhanced with fatty foods. The medication is generally well-tolerated with minimal side effects in the pediatric population 4.