de Silva N, Guyatt H, Bundy D
Wellcome Trust Centre for the Epidemiology of Infectious Disease, Department of Zoology, University of Oxford, UK.
Drugs. 1997 May;53(5):769-88. doi: 10.2165/00003495-199753050-00004.
Virtually all the important helminth infections in humans can be treated with one of 5 anthelmintics currently in use: albendazole, mebendazole, diethylcarbamazine, ivermectin and praziquantel. These drugs are vital not only for the treatment of individual infections, but also useful in controlling transmission of the more common infections. This article reviews briefly the pharmacology of these 5 drugs, and then discusses current issues in the use of anthelmintics in the treatment and/or control of soil-transmitted nematode infections, filariasis, onchocerciasis, schistosomiasis (and other trematode infections), neurocysticercosis and hydatidosis. Mebendazole and albendazole are most effective against intestinal nematodes, but are contraindicated during the first trimester of pregnancy. The efficacy of prolonged therapy with these 2 drugs for treatment of larval cestode infections has not yet been established. Diethylcarbamazine is widely used to treat and control lymphatic filariasis, but adverse effects related to death of microfilariae or damage to adult worms may be marked. While ivermectin has been used in the treatment of patients with onchocerciasis, it is also undergoing investigation against lymphatic filariae. Praziquantel, used to treat schistosome infections, is also effective in other trematode infections and adult cestode infections.
实际上，人类所有重要的蠕虫感染都可用目前正在使用的5种驱虫药之一进行治疗：阿苯达唑、甲苯达唑、乙胺嗪、伊维菌素和吡喹酮。这些药物不仅对个体感染的治疗至关重要，而且在控制较常见感染的传播方面也很有用。本文简要回顾了这5种药物的药理学，然后讨论了在治疗和/或控制土壤传播的线虫感染、丝虫病、盘尾丝虫病、血吸虫病（及其他吸虫感染）、神经囊尾蚴病和包虫病时使用驱虫药的当前问题。甲苯达唑和阿苯达唑对肠道线虫最有效，但在妊娠头三个月禁用。这两种药物长期治疗幼虫绦虫感染的确切疗效尚未确定。乙胺嗪广泛用于治疗和控制淋巴丝虫病，但与微丝蚴死亡或成虫损伤相关的不良反应可能很明显。虽然伊维菌素已用于治疗盘尾丝虫病患者，但也正在针对淋巴丝虫病进行研究。用于治疗血吸虫感染的吡喹酮对其他吸虫感染和成虫绦虫感染也有效。
