Child With Hydatid Disease - Pediatric Oncall

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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Question
A 6 year old child with hydatid disease of Right lung underwent surgery yesterday. Is it necessary to give albendazole and for how long?
Answer
Chemotherapy is indicated in patients with primary liver or lung cysts that are inoperable (because of location or medical condition), patients with cysts in 2 or more organs, and peritoneal cysts. In the treatment of hydatid cyst of the lung, conservative surgical methods such as cystotomy and capitonnage still remain the treatment of choice. Adjunctive chemotherapy before and after surgery appears to reduce the risk of recurrence by inactivating protoscolices and reduces the tension of the cysts for easier cyst removal. If spillage of the cyst contents occurs, either spontaneously or following iatrogenic manipulation, it is recommended that either mebendazole or albendazole be given to reduce the risk of secondary hydatidosis. However, the optimal duration of chemotherapy before and after surgical procedures is not known. Therapy generally should begin 4 days prior to surgery and be continued for 1-3 months. The usual dose of mebendazole is 40-50 mg/kg body weight/day, given in three divided doses after meals (maximum daily dose 6 g). Therapy is usually indicated for 3-6 months. Albendazole is given at a dosage of 10-15 mg/kg body weight/day in two divided doses and the usual dose is 800 mg daily. Therapy is most often indicated for a minimum of 3-6 months. Albendazole is preferred because it has better bio-availability. Ref: Mawhorter S, Temeck B, Chang R, Pass H, Nash T. Nonsurgical therapy for pulmonary hydatid cyst disease. Chest 1997;112:1432:1436. Kilani T, El Hammami S. Pulmonary hydatid and other lung parasitic infections. Curr Opin Pulm Med 2002;8:218:223. Anadol D, Ozcelik U, Kiper N, Gocmen A. Treatment of hydatid disease. Pediatric Drugs 2001;3:123:135. Back to All Questions

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