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Evidence summaries

Ivermectin Versus Albendazole or Thiabendazole for Strongyloides Stercoralis Infection

In patients with strongyloidiasis, ivermectin results in more people cured than albendazole, and is at least as well tolerated. In trials of ivermectin with thiabendazole, parasitological cure is similar but there are more adverse events with thiabendazole. Level of evidence: "B"

The quality of evidence is downgraded by study limitations (lack of blinding, unclear allocation concealment).

Summary

A Cochrane review [Abstract] 1 included 7 studies with a total of 1147 subjects.

In trials comparing ivermectin with albendazole, parasitological cure was higher with ivermectin (RR 1.79, 95% CI 1.55 to 2.08; 478 participants, four trials). There were no statistically significant differences in adverse events (RR 0.80, 95% CI 0.59 to 1.09; 518 participants, four trials).

In trials comparing ivermectin with thiabendazole, there was little or no difference in parasitological cure (RR 1.07, 95% CI 0.96 to 1.20; 467 participants, three trials). However, adverse events were less common with ivermectin (RR 0.31, 95% CI 0.20 to 0.50; 507 participants; three trials).

In trials comparing different dosages of ivermectin, taking a second dose of 200 μg/kg of ivermectin was not associated with higher cure in a small subgroup of participants (RR 1.02, 95% CI 0.94 to 1.11; 94 participants, two trials).

Dizziness, nausea, and disorientation were commonly reported in alldrug groups. There were no reports of serious adverse events or death

Clinical comments

Note

Date of latest search: 24-8-2015

References

  • Henriquez-Camacho C, Gotuzzo E, Echevarria J et al. Ivermectin versus albendazole or thiabendazole for Strongyloides stercoralis infection. Cochrane Database Syst Rev 2016;(1):CD007745. [PubMed]

Primary/Secondary Keywords