Diphyllobothriasis medical therapy: Difference between revisions

	Diphyllobothriasis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Diphyllobothriasis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT Scan
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Diphyllobothriasis medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
slides
Images
American Roentgen Ray Society Images of Diphyllobothriasis medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Diphyllobothriasis medical therapy
CDC on Diphyllobothriasis medical therapy
Diphyllobothriasis medical therapy in the news
Blogs on Diphyllobothriasis medical therapy
Directions to Hospitals Treating Diphyllobothriasis
Risk calculators and risk factors for Diphyllobothriasis medical therapy

VisualWikitext

Latest revision as of 21:24, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2], Furqan M M. M.B.B.S [3]

Overview

Medical therapy is the primary modality of treatment for diphyllobothriasis. Drugs used for diphyllobothriasis include either praziquantel or niclosamide.

Medical Therapy

The medications used in the treatment of diphyllobothriasis are:^[1]^[2]

Antimicrobial Regimen

The dose for empiric treatment of diphyllobothriasis is as follows:^[1]^[2]

Diphyllobothriasis
- 1.1 Adult
  - Preferred regimen (1): Praziquantel 5-10 mg/kg orally in a single-dose therapy.
  - Alternative regimen (1): Niclosamide 2 gm single dose orally for adults.
- 1.2 Children
  - Preferred regimen (1): Praziquantel 5-10 mg/kg orally in a single-dose therapy.
  - Alternative regimen (1): Niclosamide 50 mg/kg (max 2 gm) orally once.

Mechanism of action

Praziquantel
- Oral praziquantel is available for human use in the United States. Praziquantel increases the permeability of the cell membrane towards calcium ions. This induces contraction of the parasites, resulting in paralysis in the contracted state.
Niclosamide
- Niclosamide inhibits the oxidative phosphorylation and anaerobic metabolism in the parasites.

References

↑ ^1.0 ^1.1 "CDC - DPDx - Diphyllobothriasis".
↑ ^2.0 ^2.1 Scholz T, Garcia HH, Kuchta R, Wicht B (2009). "Update on the human broad tapeworm (genus diphyllobothrium), including clinical relevance". Clin. Microbiol. Rev. 22 (1): 146–60, Table of Contents. doi:10.1128/CMR.00033-08. PMC 2620636. PMID 19136438.

Template:WH Template:WS

[urlCDC_-_DPDx_-_Diphyllobothriasis-1] 1.0 ^1.1 "CDC - DPDx - Diphyllobothriasis".

[pmid19136438-2] 2.0 ^2.1 Scholz T, Garcia HH, Kuchta R, Wicht B (2009). "Update on the human broad tapeworm (genus diphyllobothrium), including clinical relevance". Clin. Microbiol. Rev. 22 (1): 146–60, Table of Contents. doi:10.1128/CMR.00033-08. PMC 2620636. PMID 19136438.

[1]

[2]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Diphyllobothriasis}}
-{{CMG}} {{AE}} {{KD}}
+{{CMG}}; {{AE}} {{KD}}, {{MMF}}
 ==Overview==
+Medical therapy is the primary modality of treatment for [[diphyllobothriasis]]. Drugs used for [[diphyllobothriasis]] include either [[praziquantel]] or [[niclosamide]].
 ==Medical Therapy==
+The medications used in the treatment of [[diphyllobothriasis]] are:<ref name="urlCDC - DPDx - Diphyllobothriasis">{{cite web |url=https://www.cdc.gov/dpdx/diphyllobothriasis/index.html |title=CDC - DPDx - Diphyllobothriasis |format= |work= |accessdate=}}</ref><ref name="pmid19136438">{{cite journal |vauthors=Scholz T, Garcia HH, Kuchta R, Wicht B |title=Update on the human broad tapeworm (genus diphyllobothrium), including clinical relevance |journal=Clin. Microbiol. Rev. |volume=22 |issue=1 |pages=146–60, Table of Contents |year=2009 |pmid=19136438 |pmc=2620636 |doi=10.1128/CMR.00033-08 |url=}}</ref>
+*[[Praziquantel]]
+*[[Niclosamide]]
+===Antimicrobial Regimen===
-===Praziquantel===
+The dose for empiric treatment of [[diphyllobothriasis]] is as follows:<ref name="urlCDC - DPDx - Diphyllobothriasis">{{cite web |url=https://www.cdc.gov/dpdx/diphyllobothriasis/index.html |title=CDC - DPDx - Diphyllobothriasis |format= |work= |accessdate=}}</ref><ref name="pmid19136438">{{cite journal |vauthors=Scholz T, Garcia HH, Kuchta R, Wicht B |title=Update on the human broad tapeworm (genus diphyllobothrium), including clinical relevance |journal=Clin. Microbiol. Rev. |volume=22 |issue=1 |pages=146–60, Table of Contents |year=2009 |pmid=19136438 |pmc=2620636 |doi=10.1128/CMR.00033-08 |url=}}</ref>
-Oral [[praziquantel]] is available for human use in the United States.
-====Note on Treatment in Pregnancy====
-Praziquantel is [[pregnancy]] category B. There are no adequate and well-controlled studies in pregnant women. However, the available evidence suggests no difference in adverse birth outcomes in the children of women who were accidentally treated with praziquantel during mass prevention campaigns compared with those who were not. In mass prevention campaigns for which the World Health Organization (WHO) has determined that the benefit of treatment outweighs the risk, WHO encourages the use of praziquantel in any stage of pregnancy. For individual patients in clinical settings, the risk of treatment in pregnant women who are known to have an infection needs to be balanced with the risk of disease progression in the absence of treatment.
-Pregnancy Category B: Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the first trimester (and there is no evidence of a risk in later trimesters).
-====Note on Treatment During Lactation====
-Praziquantel is excreted in low concentrations in human milk. According to WHO guidelines for mass prevention campaigns, the use of praziquantel during [[lactation]] is encouraged. For individual patients in clinical settings, praziquantel should be used in breast-feeding women only when the risk to the infant is outweighed by the risk of disease progress in the mother in the absence of treatment.
-====Note on Treatment in Pediatric Patients====
-The safety of praziquantel in children aged less than 4 years has not been established. Many children younger than 4 years old have been treated without reported adverse effects in mass prevention campaigns and in studies of [[schistosomiasis]]. For individual patients in clinical settings, the risk of treatment of children younger than 4 years old who are known to have an infection needs to be balanced with the risk of disease progression in the absence of treatment.
-===Niclosamide===
+* '''Diphyllobothriasis'''
-Niclosamide is NOT available for human use in the United States.
+** 1.1 '''Adult'''
-====Note on Treatment in Pregnancy====
+***Preferred regimen (1): [[Praziquantel]] 5-10 mg/kg orally in a single-dose therapy.
-Niclosamide is in pregnancy category B. Data on the use of niclosamide in pregnant women are limited. Niclosamide is not thought to be systemically absorbed. Niclosamide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
+*** Alternative regimen (1): [[Niclosamide]] 2 gm single dose orally for adults.
+** 1.2 '''Children'''
+***Preferred regimen (1): [[Praziquantel]] 5-10 mg/kg orally in a single-dose therapy.
+*** Alternative regimen (1): [[Niclosamide]] 50 mg/kg (max 2 gm) orally once.
-Pregnancy Category B: Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the first trimester (and there is no evidence of a risk in later trimesters).
+===Mechanism of action===
-====Note on Treatment During Lactation====
+#[[Praziquantel]]
+#*Oral [[praziquantel]] is available for human use in the United States. Praziquantel increases the permeability of the cell membrane towards calcium ions. This induces contraction of the parasites, resulting in paralysis in the contracted state.
-It is not known whether niclosamide is excreted in breast milk, although niclosamide is not thought to be systemically absorbed. The World Health Organization (WHO) classifies niclosamide as compatible with breastfeeding, although data on the use of niclosamide during lactation are limited.
+#[[Niclosamide]]
-====Note on Treatment in Pediatric Patients====
+#*[[Niclosamide]] inhibits the oxidative phosphorylation and anaerobic metabolism in the parasites.
-The safety of niclosamide in children has not been established, although niclosamide is not thought to be systemically absorbed. Available evidence suggests that the safety profiles are comparable in children 2 years or older and adults.
-;Shown below is a table summarizing the preferred and alternative empiric treatment for Diphyllobothriasis<ref>http://www.cdc.gov/parasites/diphyllobothrium/health_professionals/index.html</ref>
-{| class="wikitable" border="1" style="background:FloralWhite"
-|- align="center"
-|'''Pathogens'''
-|'''Preferred Treatment'''
-|'''Duration of Treatment'''
-|'''Alternative Treatment'''
-|- align="center"
-| Diphyllobothrium latum
-|'''Praziquantel'''*
-Adults, 5-10 mg/kg orally in a single-dose therapy; the dosage for children is the same.
-| Single dose
-|'''Niclosamide'''
-Adult 2 gm orally once; children, 50 mg/kg (max 2 gm) orally once.
-|}
-(Note: praziquantel should be taken with liquids during a meal.)*
 ==References==
 {{reflist|2}}
+{{WH}}
+{{WS}}
 [[Category:Disease]]
-[[Category: Foodborne illnesses]]
+[[Category:Foodborne illnesses]]
+[[Category:Needs overview]]
+[[Category:Emergency medicine]]
+[[Category:Up-To-Date]]
 [[Category:Infectious disease]]
+[[Category:Gastroenterology]]
-{{WH}}
-{{WS}}