CHEMOTHERAPY OF ALVEOLAR ECHINOCOCCOSIS WITH BENZIMIDAZOLES - A PROSPECTIVE

Background: Mebendazole and albendazole are the drugs of choice for th e treatment of alveolar echinococcosis. In this prospective study we p resent and evaluate the outcome of the long-term treatment with both d rugs. Patients and Methods: Forty-four patients were treated with eith er mebendazole or albendazole and they were followed up for an average of 42 months. Success of treatment was defined as non-progression for more than 1 year. Results: The overall success-rate was approximately 80% (35/44). An initial regimen was recurrence-free in 64% of cases u nder mebendazole and in 73% of cases under albendazole. Half of the ca ses with recurrent disease could be stabilized after changing the ther apeutic regimen. Seven patients received a continuous regimen with alb endazole. They were observed over an average of 19 months without sign s of progression nor significant side effects. Conclusion: This open-l abelled prospective study demonstrates the high therapeutic efficacy o f bothmebadazole and albendazole with similar response rates in the tr eatment of alveolar echinococcosis. In Germany, serum levels for meben dazole can easily be obtained at numerous institutes, while serum leve ls for albendazole are rarely available. On the other hand. albendazol e reduces costs by over 40%. A simplified mode of intake and a reduced number of side effects argue in favor of the preferred use of albenda zole. Albendazole in alveolar echinococcosis is only licensed for inte rmittent application. Nontheless, continuous treatment may be consider ed in inoperable cases or progressive disease.