Indian Pediatrics - Editorial

Readers’ Forum

Indian Pediatrics 2008; 45:157

Readers Forum

Q. Is the drug combination of ivermectin and albendazole a rational combination. If yes, what is the dose and what is the safety profile?

Gopimohan R. Gopinivas,
Olai, Thevally PO,
Kollam 691 009, Kerala,
India.
Email: [email protected]

A. Ivermectin and albendazole combination is a rational combination for the treatment and prophylaxis of lymphatic filariasis caused by Wuchereria bancrofti(1,2). For trichuriasis, albendazole + Ivermectin gives significantly higher cure and egg reduction rates than the other treatments and significantly reduces prevalence rates of the illness(3,4). Combination therapy also results in significantly greater gains in height (hookworm-infected children) or weight (Trichuris-infected children) compared with the placebo group( 4). However, the combination was not significantly more effective in treatment of other helminthic infestations. There is not enough data on the superiority of this combination over ivermectin alone in difficult to treat ectoparasitic infections like hyperkeratotic (crusted or ‘Norwegian’) scabies, pediculosis and cutaneous larva migrans. The dose in cases where it is indicated is a single dose combination tablet of albendazole and ivermectin in children older than 5 years of age.

Jeeson C Unni,
Editor-in-Chief,
IAP Drug Formulary,
Dr Kunhalu’s Nursing Home,
Cochin 682 011, India.
Email: [email protected]

References

1. Richards FO Jr, Pam DO, Kal A, Gerlong GY, Onyeka J, Sambo Y, et al. Significant decrease in the prevalence of Wuchereria bancrofti infection in anopheline mosquitoes following the addition of albendazole to annual, ivermectin-based, mass treatments in Nigeria. Annals Trop Med Parasitol 2005; 99: 155-164.

2. Ismail MM, Jayakody RL, Weil GJ, Fernando D, DeSilva MS, DeSilva GA, et al. Long-term efficacy of single-dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis. Trans R Soc Trop Med Hyg 2001; 95: 332-325.

3. Belizario VY, AmarilIo ME, de Leon WU, de Ios Reyes AE, Bugayong MG, Macatangay BJ. A comparison of the efficacy of single dose of alben-dazole, ivermectin, and diethylcarbamazine alone or in combinations against Ascaris and Trichuris spp. Bull World Health Organ 2003; 81; 35-42.

4. Beach MJ, Streit TG, Addiss DG, Prospere R, Roberts JM, Lammie PJ. Assessment of combined ivermectin and albendazole for treatment of intestinal helminth and Wuchereria bancrofti infections in Haitian school children. Am J Trop Med Hyg 1999; 60: 479-486.