Gann P H, Neva F A, Gam A A
Department of Preventive Medicine, Northwestern University Medical School, Chicago, Illinois 60611.
J Infect Dis. 1994 May;169(5):1076-9. doi: 10.1093/infdis/169.5.1076.
A randomized trial is described comparing ivermectin and thiabendazole for treatment of chronic infection with Strongyloides stercoralis. Subjects received ivermectin (200 micrograms/kg) in a single dose, ivermectin (200 micrograms/kg) on 2 consecutive days, or thiabendazole (50 mg/kg/day) twice daily for 3 consecutive days. Most subjects (94%) had intermittent symptoms, including urticaria, epigastric pain, and diarrhea. Stools were examined 7 days and 1, 3, 6, 10, and 22 months after treatment. Fifty-three subjects completed at least 3 months of follow-up. Only 1 of 34 and 2 of 19 ivermectin and thiabendazole subjects, respectively, had a stool positive for larvae after treatment. Symptoms were relieved in all 3 groups and eosinophil levels returned to normal in 90% of all subjects by 12 months. Nearly 95% of thiabendazole subjects had short-term adverse effects during therapy versus only 18% of those treated with ivermectin. One dose of ivermectin provides safety and efficacy equivalent to thiabendazole with a much lower prevalence of side effects and, consequently, better compliance.
本文描述了一项比较伊维菌素和噻苯达唑治疗粪类圆线虫慢性感染的随机试验。受试者分别接受单剂量伊维菌素（200微克/千克）、连续2天服用伊维菌素（200微克/千克）或连续3天每日2次服用噻苯达唑（50毫克/千克/天）。大多数受试者（94%）有间歇性症状，包括荨麻疹、上腹部疼痛和腹泻。在治疗后7天以及1、3、6、10和22个月检查粪便。53名受试者完成了至少3个月的随访。伊维菌素组34名受试者中只有1名、噻苯达唑组19名受试者中只有2名在治疗后粪便中幼虫呈阳性。所有3组的症状均得到缓解，到12个月时所有受试者中90%的嗜酸性粒细胞水平恢复正常。近95%的噻苯达唑受试者在治疗期间有短期不良反应，而伊维菌素治疗的受试者中只有18%有不良反应。单剂量伊维菌素提供了与噻苯达唑相当的安全性和疗效，副作用发生率低得多，因此依从性更好。
