drugs

Drugs for treating schistosomiasis

Definition

Bilharziosis, known to most as schistosomiasis, is a parasitosis such as teniasis, triggered by flatworms belonging to the genus Schistosoma; in schistosomiasis, the parasites reach the bloodstream, causing damage in the affected site (eg intestine, rectum, spleen, liver, lung, etc.). Schistosomiasis ranks second among the most widespread parasites in the tropics (the primacy belongs to malaria).

Causes

The species most involved in schistosomiasis are Schistosoma mansoni, Schistosoma haematobium, Schistosoma japonicum : we are talking about flatworms that infect humans by ingestion or contact with contaminated water. The intermediate host is represented by particular molluscs in which the Schistosoma larvae replicate; the latter are therefore released into the water, infecting it.

Symptoms

The clinical-symptomatological picture that distinguishes schistosomiasis depends on the infecting species; acute schistosomiasis begins with fever, anorexia, headache, cough, hepatic / splenomegaly and enlarged lymph nodes.

The intestinal variant is marked by mostly intestinal symptoms, such as diarrhea with possible emission of blood, intestinal ulcers and intestinal polyps. The schistosomiasis of the urinary tract manifests itself instead with pain during urination, haematuria and frequent urination. Finally, the cutaneous form of the disease begins with skin rash, itching and dermatitis.

Information on Schistosomiasis - Drugs for the treatment of Schistosomiasis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Schistosomiasis - Schistosomiasis Drugs.

drugs

Schistosomiasis must be treated from the earliest symptoms, to avoid the development of its complications, such as kidney failure, increased risk of kidney cancer, liver fibrosis, cirrhosis, bleeding esophageal varices and portal hypertension. Although less fatal than malaria, schistosomiasis must still be diagnosed, and therefore treated, promptly: for diagnosis it is necessary to search for Schistosoma eggs in faeces and / or urine; alternatively, it is possible to undergo antibody tests starting from the patient's blood samples. The biopsy is reserved only for those severe cases, in which schistosomiasis causes complications in internal organs.

The excellent drug used to treat schistosomiasis is praziquantel, also used in therapy for the treatment of teniasis.

In the past, other drugs were also used (eg lucanthone, niridazole, oxamnichine and sodium stibocaptoate), currently little in use due to their poorer efficacy compared to praziquantel.

Only in the case of complications of the contral nervous system, treatment with corticosteroids is conceivable.

  • Praziquantel (eg Droncit, Tremazol): it is one of the most widely used anthelmintic drugs for treating schistosomiasis; the active principle works by increasing the membrane permeability of the parasite, causing paralysis. The drug should initially be taken at a dose of 20mg / kg; after 4-6 hours, repeat the same administration. For schistosomiasis supported by S. japonicum, it is recommended to administer the drug at higher doses (60 mg / kg, in triple dose over 24 hours). For the treatment of schistosomiasis in children, the recommended dose suggests taking 70 mg / kg orally on the first day (equally divided into three doses). After 30 days from the end of the treatment, it is possible to follow another therapeutic cycle.
  • Oxamnichina (eg Vansil): the drug is effective only against S. mansoni- supported infections. As an indication, take the drug at a dose of 15 mg / kg, in a single administration. In some areas, where the disease is endemic, higher doses (30 mg / kg) are recommended.
  • Metrifonate (eg Neguvon): second-choice drug for the treatment of schistosomiasis; it is used, in particular, for the regression of chronic complications caused by the disease. Administer the drug in three doses, at intervals of 14 days from each other. It appears that the drug in question is even more effective than the Praziquantel; despite this, Metrifonate is less used in therapy because of its high cost. For the dosage: consult a doctor.

The patient is advised to undergo clinical checks after 3 and 6 months from the end of the therapy, to verify the possible presence of other live Schistosoma eggs; in this case, we recommend a further course of therapy which, in all probability, will lead to complete remission from schistosomiasis.