What is strongyloides infection and how might ivermectin work
Strongyloides stercoralis is a parasite that lives in the gut of infected people. The infection is not serious for most people, but it can be fatal in people with immune deficiency. People become infected when they come in contact with soil or water contaminated with infectious worms. The chronic infection usually causes skin rash, vomiting, diarrhoea, and constipation, and respiratory problems, such as asthma-like illness. This disease may be treated with ivermectin or albendazole or thiabendazole. We wanted to know if ivermectin was better or worse than the other alternative therapies.
What the research says
We reviewed the evidence about the effect of ivermectin compared with albendazole and thiabendazole. After searching for relevant trials up to August 2015, we included seven randomized controlled trials, enrolling 1147 adults with chronic strongyloides infection, conducted between 1994 and 2011 in different locations (Africa, Southeast Asia, America, and Europe). Four trials assessed the effectiveness of ivermectin compared with albendazole and three trials assessed the effectiveness of ivermectin compared with thiabendazole.
Comparison ivermectin versus albendazole
Treatment with ivermectin probably cures more people than albendazole (moderate quality evidence), and may be equally or better tolerated (low quality evidence). The included trials did not report serious adverse events or death.
Comparison ivermectin versus thiabendazole
Treatment with ivermectin and thiabendazole may cure similar numbers of people with strongyloides infection (low quality evidence), but ivermectin is probably better tolerated (moderate quality evidence). The included trials did not report serious adverse events or death.
Henriquez-Camacho, C.; Gotuzzo, E.; Echevarria, J.; White Jr., A.C.; Terashima, A.; Samalvides, F.; Pérez-Molina, J.A.; Plana, M.N. Ivermectin versus albendazole or thiabendazole forStrongyloides stercoralisinfection. Cochrane Database of Systematic Reviews (2016) Issue 1, Art. No.: CD007745. [DOI: 10.1002/14651858.CD007745.pub3]