Strongyloides Stercoralis - Treatment

Treatment

Ideally, prevention, by improved sanitation (proper disposal of feces), practicing good hygiene (washing of hands), etc., is used before any drug regimen is administered.

Ivermectin is the drug of first choice for treatment because of higher tolerance in patients. Thiabendazole was used previously, but, owing to its high prevalence of side effects (dizziness, vomiting, nausea, malaise) and lower efficacy, it has been superseded by ivermectin and as second-line albendazole. However, these drugs have little effect on the majority of these autoinfective larvae during their migration through the body. Hence, repeated treatments with ivermectin must be administered to kill adult parasites that develop from the autoinfective larvae.

In the UK, mebendazole and piperazine are currently (2007) preferred. Mebendazole has a much higher failure rate in clinical practice than albendazole, thiabendazole, or ivermectin.

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