Albendazole therapy for loiasis refractory to diethylcarbamazine treatment

Although diethylcarbamazine is curative in similar to 60% of patients who a cquire loiasis as long-term visitors to an endemic area, some individuals c ontinue to have signs and symptoms of infection despite multiple courses of diethylcarbamazine. On the basis of a study of albendazole treatment of lo iasis in microfilaremic patients that suggested a macrofilaricidal effect o f the drug, we treated three patients who had symptomatic loiasis refractor y to more than four courses of diethylcarbamazine with albendazole. At the time of treatment, ail patients had persistent symptoms despite decreasing titers of antifilarial antibodies and normal eosinophil counts. Symptoms re solved in all three patients following albendazole therapy. In one patient, nonspecific symptoms recurred 2 years later, but unlike her symptoms befor e albendazole therapy, they were not accompanied by the appearance of subcu taneous nodules containing adult worms. The other two patients have been sy mptom-free in the 8 years after albendazole treatment. In summary, albendaz ole may be useful for the treatment of loiasis when diethylcarbamazine is i neffective or cannot be used.