EFFICACY AND TOLERANCE OF PRAZIQUANTEL (B ILTRICIDE(R)) IN PATIENTS WITH DISTOMATOSIS DUE TO FASCIOLA-HEPATICA

Objectives. - Due to the side-effects of dehydroemetine, we have chose n praziquantel, a broad-spectrum antihelmintic, as a treatment for dis tomatosis secondary to Fasciola hepatica in humans. The aim of this re trospective study was to evaluate the efficacy and tolerance to praziq uantel in patients with this disease. Methods. - Twenty-five patients (12 men) with a definite diagnosis of distomatosis and no previous tre atment were followed-up between 8 months and 3 years (>18 months in 76 % of cases). The follow-up was based on clinical, biochemical and ser ological criteria. All patients received praziquantel (75 mg/kg/day or ally for 5 days. Treatment was started after endoscopic or surgical re moval of parasites locolized in the biliary tract, in two patients. A similar therapeutic course was administered twice in four patients wit h persistent clinical symptoms, hyperosinophilia or arch 2 on immunoel ectrophoresis. Results. - Cumulative rates of patients with normalized eosinophilia and seronegativation at 6, 9 and 12 months were 55, 65, 75 % and 55, 70, 100 %, respectively. Complete recovery occurred in 18 patients (72 %) whereas hyper eosinophilia persisted for more than on e year in 5 patients. No side-effects, except transient nausea in a fe w cases, were observed. Conclusion. - Since praziquantel seems to be b oth effective and well tolerated in a large proportion of patients, th is drug can be recommended as a first choice for distomatosis due to F asciola hepatica in human.