A single dose of doxycycline in combination with diethylcarbamazine for treatment
of bancroftian filariasis.
Author(s): Sanprasert V, Sujariyakul A, Nuchprayoon S.
Affiliation(s): Lymphatic Filariasis Research Unit, Department of Parasitology, Chulalongkorn
University, Bangkok, Thailand.
Publication date & source: 2010, Southeast Asian J Trop Med Public Health. , 41(4):800-12
Standard treatment of lymphatic filariasis with diethylcarbamazine (DEC) is
associated with systemic adverse reactions, thought to be due to the release of
microfilariae material and Wolbachia endosymbiotic bacteria into the blood.
Combination treatments with doxycycline for 3-8 weeks are more effective than
standard treatment. However, long-term use of antibiotics may contribute to drug
resistance and are not practical for use in remote areas. We assessed whether a
single dose of doxycycline combined with the standard DEC regimen would reduce
the incidence and severity of adverse reactions and increase the efficacy of
standard treatment. Forty-four subjects from Tak Province were recruited into the
randomized double-blind clinical trial study: 25 received DEC (300 mg) combined
with a placebo, and 19 received DEC (300 mg) combined with doxycycline (200 mg).
The incidences of adverse reactions to standard treatment were lower in the
doxycycline group (45.5%) than in the placebo group (58.8%). Severe reactions
occurred only in the placebo group (3 of 25 subjects). The severity of adverse
reactions was significantly lower in the doxycycline group (mean score 0.45) than
in the placebo group (mean score 1.17). The levels of IL-6 and Wolbachia DNA in
the plasma were significantly lower in the doxycycline group. The filarial
antigen levels were significantly lower in the doxycycline group at months 6
after treatment.
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