阿苯达唑的治疗失败率比伊维菌素高 20%~30%。[11]Loutfy MR, Wilson M, Keystone JS, et al. Serology and eosinophil count in the diagnosis and management of strongyloidiasis in a non-endemic area. Am J Trop Med Hyg. 2002;66:749-752.http://www.ajtmh.org/cgi/reprint/66/6/749http://www.ncbi.nlm.nih.gov/pubmed/12224585?tool=bestpractice.com[29]Suputtamongkol Y, Kungpanichkul N, Silpasakorn S, et al. Efficacy and safety of a single-dose veterinary preparation of ivermectin versus 7-day high-dose albendazole for chronic strongyloidiasis. Int J Antimicrob Agents. 2008;31:46-49.http://www.ncbi.nlm.nih.gov/pubmed/18023151?tool=bestpractice.com[30]Marti H, Haji HJ, Savioli L, et al. A comparative trial of a single dose ivermectin versus three days of albendazole for treatment of Strongyloides stercoralis and other soil transmitted helminth infections in children. Am J Trop Med Hyg. 1996;55:477-481.http://www.ncbi.nlm.nih.gov/pubmed/8940976?tool=bestpractice.com[32]Nontasut P, Muennoo C, Sa-nguankiat S, et al. Prevalence of strongyloides in Northern Thailand and treatment with ivermectin vs albendazole. Southeast Asian J Trop Med Public Health. 2005;36:442-444.http://www.ncbi.nlm.nih.gov/pubmed/15916052?tool=bestpractice.com[33]Turner SA, Maclean JD, Fleckenstein L, et al. Parenteral administration of ivermectin in a patient with disseminated strongyloidiasis. Am J Trop Med Hyg. 2005;73:911-914.http://www.ajtmh.org/cgi/content/full/73/5/911http://www.ncbi.nlm.nih.gov/pubmed/16282302?tool=bestpractice.com[34]Toma H, Sato Y, Shiroma Y, et al. Comparative studies on the efficacy of three anti-helminthics on treatment of human strongyloidiasis in Okinawa, Japan. Southeast Asian J Trop Med Public Health 2000;31:147-151.http://www.ncbi.nlm.nih.gov/pubmed/11023084?tool=bestpractice.com[35]Suputtamongkol Y, Premasathian N, Bhumimuang K, et al. Efficacy and safety of single and double doses of ivermectin versus 7-day high dose albendazole for chronic strongyloidiasis. PLoS Negl Trop Dis. 2011;5:e1044.http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0001044http://www.ncbi.nlm.nih.gov/pubmed/21572981?tool=bestpractice.com 所有幼虫均需根除,否则自体感染会继续无限期地导致类圆线虫感染。 接受 2 个剂量伊维菌素治疗的人群,65%~80% 在 6 个月后会恢复到血清学结果阴性或定量滴度减少 40%。[37]Kobayashi J, Sato Y, Toma H, et al. Application of enzyme immunoassay for postchemotherapy evaluation of human strongyloidiasis. Diagn Microbiol Infect Dis. 1994;18:19-23.http://www.ncbi.nlm.nih.gov/pubmed/8026153?tool=bestpractice.com 血清学滴度增加提示须考虑治疗失败。 在迁移难民离开其原来国家/地区之前给予阿苯达唑,该策略可导致新到达难民类圆线虫的可检测率降低。[38]Swanson SJ, Phares CR, Mamo B, et al. Albendazole therapy and enteric parasites in United States–bound refugees. N Engl J Med. 2012;366:1498-1507.http://www.ncbi.nlm.nih.gov/pubmed/22512482?tool=bestpractice.com 大量人的粪便检查结果可能呈假阴性,伴有未检测到的慢性感染。
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