Blinded, placebo-controlled trial of antiparasitic drugs for trichinosis myositis.

Author(s): Watt G, Saisorn S, Jongsakul K, Sakolvaree Y, Chaicumpa W

Affiliation(s): HIV Interaction Section, Department of Retrovirology, Armed Forces Research Institute of Medical Sciences, APO AP 96546. wattgh@thai.amedd.army.mil

Publication date & source: 2000-07, J Infect Dis., 182(1):371-4. Epub 2000 Jun 30.

Publication type: Clinical Trial; Randomized Controlled Trial

There is no consensus on the benefits of treatment with any specific anthelminthic compound on muscle-stage trichinosis. A double-blind, placebo-controlled comparison was done of 3 antiparasitic drugs during an outbreak of trichinosis in Chiangrai Province, northern Thailand. Forty-six adults were randomized to receive 10 days of oral treatment with mebendazole (200 mg twice a day), thiabendazole (25 mg/kg twice a day), fluconazole (400 mg initially, then 200 mg daily), or placebo. All patients received treatment to eradicate adult intestinal worms. Trichinella spiralis infection was proved parasitologically in 19 (41%) of 46 patient and by serodiagnosis in all cases. Significantly more patients improved after treatment with mebendazole (12/12) and thiabendazole (7/7) than after treatment with placebo (6/12; P<.05) or fluconazole (6/12). Muscle tenderness resolved in more patients treated with thiabendazole and mebendazole than in those treated with placebo (P<.05). However, 30% of volunteers could not tolerate the side effects of thiabendazole. In summary, Trichinella myositis responds to thiabendazole and to mebendazole.