Portugal R, Nucci M, Schaffel R, Almeida L, Spector N, Pulcheri W; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1998 Sep 24-27; 38: 407 (abstract no. I-143a).
University Hospital, Rio de Janeiro, Brazil.
In a previous study, we have found that 53 out of 253 patients with hematological malignancies had positive stool examinations for Strongyloides stercoralis. In order to evaluate the efficacy of thiabendazole in the prophylaxis of strongyloidiasis in immunosuppressed patients we conducted a prospective double-blind placebo-controlled randomized trial. The study group consisted of patients with hematological malignancies and patients with benign hematological conditions receiving corticosteroids. Eligible patients were screened with 3 stool examinations (Baerman's method) and if negative they were randomly allocated to receive thiabendazole 25 mg/kg PO twice daily for 2 days once every month (group 1) or placebo (group 2). Stool examinations were performed every month and the regimen was discontinued in case of side effects attributable to thiabendazole or if the diagnosis of strongyloidiasis was made. The patients were followed for 6 months. Between May 1995 and April 1997, 49 patients received thiabendazole and 54 received placebo. Lymphoma was the most frequent underlying disease (59% in both groups). The two groups were comparable in terms of underlying diseases, gender, age, use of corticosteriods and the following clinical complaints: diarrhea, abdominal pain, itching, nausea, cough and fever. There were 4 cases of strongyloidiasis in group 2 and 1 case in group 1 (7.4% versus 2%, p=0.36, relative risk 3.63, 95% confident interval 0.42 - 31.38). There were no cases of disseminated strongyloidiasis. The compliance was good in 55% of patients in group 1 and in 74% of patients in group 2 (p=0.04). This study does not support the use of thiabendazole prophylaxis in patients who receive immunosuppressive treatment. The frequency of the disseminated form seems to be low.
Publication Types:
Keywords:
- Adrenal Cortex Hormones
- Animals
- Double-Blind Method
- Feces
- Hematologic Diseases
- Hematologic Neoplasms
- Humans
- Immunocompromised Host
- Longitudinal Studies
- Placebos
- Strongyloides stercoralis
- Strongyloidiasis
- Thiabendazole
- immunology
- prevention & control
- therapy
Other ID:
UI: 102188293
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