Blinded, placebo-controlled trial of antiparasitic drugs for trichinosis myositis

• Main Authors: George Watt, Supachai Saisorn, Krisada Jongsakul, Yuwaporn Sakolvaree, Wanpen Chaicumpa
• Other Authors: Armed Forces Research Institute of Medical Sciences, Thailand
• Format: Article
• Published: 2018
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/26192
• Institution: Mahidol University

There is no consensus on the benefits of treatment with any specific anthelminthic compound on muscle-stage trichinosis. A double-blind, placebo- controlled comparison was done of 3 antiparasitic drugs during an outbreak of trichinosis in Chiangrai Province, northern Thailand. Forty-six adults were randomized to receive 10 days of oral treatment with mebendazole (200 mg twice a day), thiabendazole (25 mg/kg twice a day), fluconazole (400 mg initially, then 200 mg daily), or placebo. All patients received treatment to eradicate adult intestinal worms. Trichinella spiralis infection was proved parasitologically in 19 (41%) of 46 patient and by serodiagnosis in all cases. Significantly more patients imprOVed after treatment with mebendazole (12/12) and thiabendazole (7/7) than after treatment with placebo (6/12; P < .05) or fluconazole (6/12). Muscle tenderness resolved in more patients treated with thiabendazole and mebendazole than in those treated with placebo (P < .05). However, 30% of volunteers could not tolerate the side effects of thiabendazole. In summary, Trichinella myositis responds to thiabendazole and to mebendazole.