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08-07-2001
Should we use albendazole and steriods in cases of neurocysticircusis in paediatric
pts
Dr Dhirendra Kumar,
Kanpur, Uttar Pradesh. |
12-07-2001
The use of anticysterical drugs in Neurocysticercosis is presently controversial.
Praziquental 50 mg/kg/day, divided into three doses x 14 days or Albendazole 15 mg/kg/day
x 28 days. Since this therapy is known to exacerbate symptoms it is recommended to use
steroids while initiating anticysterical therapy to prevent the same. Anticonvulsants
however remain the drugs to be given when convulsions are the symptom. The duration
remains debatable. Also important to remember is to avoid anticysticercal therapy in the
acute stage of symptoms. Baranwal et al from PGIMER, Chandigarh in Pediatr Infect Dis J
1998 Aug;17(8):696-700 studied Albendazole therapy in children with focal seizures and
single small enhancing computerized tomographic lesions: a randomized, placebo-controlled,
double blind trial. They used Albendazole (15 mg/kg/ day) or placebo for 28 days and
concluded that Albendazole therapy results in significantly faster and increased
resolution of solitary cysticercus lesions (SSECTLs) and appears to reduce the risk of
late seizure recurrences. In another trail from Peru "Albendazole therapy for
neurocysticercosis: a prospective double-blind trial comparing 7 versus 14 days of
treatment. Cysticercosis Working Group in Peru", Garcia et al compared one week
versus 2 weeks of Albendazole therapy. The conclusion was that the extension of
albendazole therapy for more than 7 days adds no benefits for the patients. .
Dr Sanjiv Lewin,
Bangalore, Karnataka. |
12-07-2001
Dear Dr Dhirendra Kumar : You can use albendazol in cysticercosis in children . The
dose is 15 mg/kg/day PO divided each 12 hours . (Max dose 800 mgs). I had a good
experience using it in a child's cysticercosis 7 years old. I gave him during 8 days but
Nelson says that it could be used as long time as 28 days . The prednisona must be used
the frist dose before the first albendazole dose. Children before 2 years is a relative
contraindication because the albendazol safety is not established in them . The albendazol
also could be used for giardias same dose for 5 days. Secondary effects : ( < 5 % the
people who take the drug) Abdominal pain diarrhea,ascaris migration. Rare ( 0.01-01 % or
less) : Leukopenia Alopecia; Increased aminotrasferases)
Dr Alexis
Palencia, Bucaramanga, Colombia, South America. |
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