TREATMENT OF HUMAN PULMONARY PARAGONIMIASIS WITH TRICLABENDAZOLE - CLINICAL TOLERANCE AND DRUG EFFICACY

An open clinical trial to determine the efficacy and tolerability of p ostprandial doses of triclabendazole against Paragonimus mexicanus in 62 patients with pulmonary paragonimiasis from the Ecuadorian Amazon r egion was performed. Praziquantel was used as therapeutic control. Pat ients were allocated at random to the following 4 therapeutic regimens : triclabendazole, 5 mg/kg once daily for 3 d (16 patients), 10 mg/kg twice on one day (15 patients), and 10 mg/kg in a single dose (16 pati ents), and praziquantel, 25 mg/kg thrice daily for 3 d (15 patients). Clinical tolerance, based on the frequency and severity of adverse rea ctions, was superior in all 3 triclabendazole regimens to that of praz iquantel. No alteration was observed in hepato-renal functions or haem atological values. The clinical symptoms resolved at a comparable rate in all 4 treatment groups. A more rapid parasitological response to t reatment, as determined by the reduction in the average number of para site eggs found in sputum, was seen in patients treated with triclaben dazole than with praziquantel. By day 90, 60 patients had no egg detec ted in their sputum; 2 patients, treated with a single dose of IO mg/k g, had a few and were re-treated with triclabendazole (5 mg daily for 3 d). On day 365, none of the patients had eggs in their sputum. Tricl abendazole can be recommended as an alternative drug of choice for the treatment of pulmonary paragonimiasis; it is as effective as praziqua ntel in clearing infections and better tolerated.