treatment
Last reviewed 01/2018
Seek expert advice.
Praziquantel
- is the drug of choice and is active against all schistosome species
- acts within one hour of ingestion
- can be used to treat young children (>4 years old) and pregnant women if breastfeeding is discontinued on the day of treatment and for the next 72 hours
- dose
- S haematobium, S mansoni, S intercalatum - 40 mg/kg per day, two doses a day by mouth
- S mekongi - 60 mg/kg per day, three doses a day by mouth
- resistance to the praziquantel has been reported in Africa due to heavy exposure to the drug
Adjuvant therapy
- corticosteroids
- prednisone 1.5-2.0 mg/kg per day for three weeks is used for treatment of
- Katayama syndrome within two months of freshwater contact
- schistosomal encephalopathy during the oviposition (egg laying) stage
- together with anticonvulsants corticosteroids may be used as adjuvants to praziquantel in neuroschistosomiasis,
- help to alleviate acute allergic reactions and to prevent mass effects caused by excessive granulomatous inflammation in the CNS (1).
- anticonvulsant
- used for seizures seen in cerebral schistosomiasis (lifelong use is rarely indicated)
Other antiparasitic agents
- oxamniquine - for S mansoni (not effective against S japonicum)
- metrifonate - for S haematobium (not effective against S japonicum)
- mefloquine-artesunate - has shown promising results against S haematobium but further investigations are necessary
Chemoprophylaxis
- praziquantel cannot be used for chemoprphylaxis since it is ineffective against chistosomula (migrating larvae) that are three to 21 days old
- artemethe
- effective against juvenile schistosomes during the first 21 days of infection in animals and humans
- all immature schistosomula should be killed if given every two weeks
- efficacy of artemether based combination therapy is unclear
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