Annals of Tropical Medicine & Parasitology
ISSN: 0003-4983 (Print) 1364-8594 (Online) Journal homepage: http://www.tandfonline.com/loi/ypgh19
Low-dose niridazole in the treatment of Schistosoma mansoni S. Bassily, Z. Farid, G. I. Higashi & R. H. Watten To cite this article: S. Bassily, Z. Farid, G. I. Higashi & R. H. Watten (1979) Low-dose niridazole in the treatment of Schistosoma mansoni, Annals of Tropical Medicine & Parasitology, 73:3, 295-296, DOI: 10.1080/00034983.1979.11687261 To link to this article: http://dx.doi.org/10.1080/00034983.1979.11687261
Published online: 23 Jun 2016.
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Citing articles: 5 View citing articles
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Date: 01 September 2017, At: 05:42
Annals of Tropical Medicine and Parasitology, Vol. 73, No. 3 (1979)
Downloaded by [Australian Catholic University] at 05:42 01 September 2017
Low-dose niridazole in the treatment of Schistosoma mansoni* Niridazole (Ambilhar) is effective in the treatment of both urinary and intestinal schistosomiasis and is considered the drug of choice for the treatment of Schistosoma haematobium infection in young children (Farid et al., 1973). Adverse reactions, however, are observed when it is used in the treatment of patients with intestinal polyposis (Bassily et al., 1976) or advanced bilharzia! hepatosplenomegaly (Coutinho and Barreto, 1969) thus limiting its use in complicated schistosomiasis. This report summarizes the results of treating 17 male farmers with schistosomiasis mansoni using niridazole at a reduced daily dose of 12·5 mgfkg body weight (instead of the recommended 25 mgfkg) but extending the course to 12 days. Patients were aged 11 to 38 years (mean 18·6± 7·5) and were admitted to hospital complaining of severe bloody diarrhoea for periods varying from two months to three years; most of them also complained of abdominal pain and lassitude. All were moderately anaemic (mean haematocrit 34±3·8%) and had varying degrees of hepatosplenomegaly. The intensity of infection was measured by Bell's egg-count technique on 24-hour stool collections. Three initial stool samples were collected and only those patients who were excreting a mean of at least 10 000 eggs/24 hours were included in the study. After treatment with niridazole, patients were carefully observed for adverse reactions and electrocardiograms, liver function tests and complete blood counts were carried out once during treatment and once weekly for four weeks. Two 24-hour stool samples for quantitative egg counts were collected 12 weeks after completion of therapy. The criterion for cure was an absence oflive eggs from the stools or rectal tissue three months after the completion of therapy. Pertinent clinical data and the results of therapy are shown in Table I. Fifteen out of 17 patients (88·2%) were cured. The remaining two patients continued to pass viable eggs of S. mansoni in the stools but one of them showed a marked reduction of egg count. All patients improved rapidly following treatment and of particular significance was the rapid cessation of bloody diarrhoea within two weeks of the completion of therapy. TABLE I
Laboratory data on 17 patients treated with niridazole 12·5 mgfkg body weight for 12 days Age (yrs)
No.qf cases 17
Mean ±s.o.
18·6 ±7·5
Haematocrit% 34 ±3·8
SGPT (l.U.)
Pretreatment egg count (X l0 3 f24hours)
27 ±13
±44
62·7
No. cured 15 (88%)*
*Two patients continued to pass live eggs; they had pre-treatment egg counts of 142·6 and 29·6 and post-treatment egg counts of0·6 and 24·0 X 10 3 respectively.
X
10 3
Apart from three patients who developed the typical pulmonary eosinophilic syndrome previously described with niridazole and other antischistosomal drugs, no side-effects were observed in any patient. These three patients developed a low grade fever accompanied by cough and rhonchi, and chest radiographs showed widespread pulmonary infiltrates. Treatment was stopped for a few days and antihistamines were administered. When all symptoms had disappeared treatment was continued and completed without further side• Supported by Naval Medical Research and Development Command, NNMC, Bethesda, Md. Work Unit M0095-PN.002-5054. The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy. Reprint requests: Publication Editor, NAMRU-3, FPO New York 09527.
296
TREATMENT OF S. MANSONI WITH NIRIDAZOLE TABLE 2
Results of eosinophilic reactions in 13 (76%) of 17 patients treated with niridazole No. of cases
13
Pre-treatment Total white count Eosinophil
Mean±s.n.
661 ±3031*
%
12±7**
Post-treatment Total white count Eosinophil
12692 ±5885*
%
43±15**
Downloaded by [Australian Catholic University] at 05:42 01 September 2017
Statistical significance: • t = 3·31, P
ISSN: 0003-4983 (Print) 1364-8594 (Online) Journal homepage: http://www.tandfonline.com/loi/ypgh19
Low-dose niridazole in the treatment of Schistosoma mansoni S. Bassily, Z. Farid, G. I. Higashi & R. H. Watten To cite this article: S. Bassily, Z. Farid, G. I. Higashi & R. H. Watten (1979) Low-dose niridazole in the treatment of Schistosoma mansoni, Annals of Tropical Medicine & Parasitology, 73:3, 295-296, DOI: 10.1080/00034983.1979.11687261 To link to this article: http://dx.doi.org/10.1080/00034983.1979.11687261
Published online: 23 Jun 2016.
Submit your article to this journal
View related articles
Citing articles: 5 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ypgh19 Download by: [Australian Catholic University]
Date: 01 September 2017, At: 05:42
Annals of Tropical Medicine and Parasitology, Vol. 73, No. 3 (1979)
Downloaded by [Australian Catholic University] at 05:42 01 September 2017
Low-dose niridazole in the treatment of Schistosoma mansoni* Niridazole (Ambilhar) is effective in the treatment of both urinary and intestinal schistosomiasis and is considered the drug of choice for the treatment of Schistosoma haematobium infection in young children (Farid et al., 1973). Adverse reactions, however, are observed when it is used in the treatment of patients with intestinal polyposis (Bassily et al., 1976) or advanced bilharzia! hepatosplenomegaly (Coutinho and Barreto, 1969) thus limiting its use in complicated schistosomiasis. This report summarizes the results of treating 17 male farmers with schistosomiasis mansoni using niridazole at a reduced daily dose of 12·5 mgfkg body weight (instead of the recommended 25 mgfkg) but extending the course to 12 days. Patients were aged 11 to 38 years (mean 18·6± 7·5) and were admitted to hospital complaining of severe bloody diarrhoea for periods varying from two months to three years; most of them also complained of abdominal pain and lassitude. All were moderately anaemic (mean haematocrit 34±3·8%) and had varying degrees of hepatosplenomegaly. The intensity of infection was measured by Bell's egg-count technique on 24-hour stool collections. Three initial stool samples were collected and only those patients who were excreting a mean of at least 10 000 eggs/24 hours were included in the study. After treatment with niridazole, patients were carefully observed for adverse reactions and electrocardiograms, liver function tests and complete blood counts were carried out once during treatment and once weekly for four weeks. Two 24-hour stool samples for quantitative egg counts were collected 12 weeks after completion of therapy. The criterion for cure was an absence oflive eggs from the stools or rectal tissue three months after the completion of therapy. Pertinent clinical data and the results of therapy are shown in Table I. Fifteen out of 17 patients (88·2%) were cured. The remaining two patients continued to pass viable eggs of S. mansoni in the stools but one of them showed a marked reduction of egg count. All patients improved rapidly following treatment and of particular significance was the rapid cessation of bloody diarrhoea within two weeks of the completion of therapy. TABLE I
Laboratory data on 17 patients treated with niridazole 12·5 mgfkg body weight for 12 days Age (yrs)
No.qf cases 17
Mean ±s.o.
18·6 ±7·5
Haematocrit% 34 ±3·8
SGPT (l.U.)
Pretreatment egg count (X l0 3 f24hours)
27 ±13
±44
62·7
No. cured 15 (88%)*
*Two patients continued to pass live eggs; they had pre-treatment egg counts of 142·6 and 29·6 and post-treatment egg counts of0·6 and 24·0 X 10 3 respectively.
X
10 3
Apart from three patients who developed the typical pulmonary eosinophilic syndrome previously described with niridazole and other antischistosomal drugs, no side-effects were observed in any patient. These three patients developed a low grade fever accompanied by cough and rhonchi, and chest radiographs showed widespread pulmonary infiltrates. Treatment was stopped for a few days and antihistamines were administered. When all symptoms had disappeared treatment was continued and completed without further side• Supported by Naval Medical Research and Development Command, NNMC, Bethesda, Md. Work Unit M0095-PN.002-5054. The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy. Reprint requests: Publication Editor, NAMRU-3, FPO New York 09527.
296
TREATMENT OF S. MANSONI WITH NIRIDAZOLE TABLE 2
Results of eosinophilic reactions in 13 (76%) of 17 patients treated with niridazole No. of cases
13
Pre-treatment Total white count Eosinophil
Mean±s.n.
661 ±3031*
%
12±7**
Post-treatment Total white count Eosinophil
12692 ±5885*
%
43±15**
Downloaded by [Australian Catholic University] at 05:42 01 September 2017
Statistical significance: • t = 3·31, P
