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Posted On : 01 Dec 2024

One and half-year-old malnourished child continuously passing round worms from the mouth. I gave Mebendazole for three days but passed worms after three days of treatment. I have asked for Piperazine citrate in the market but it is not available. What to do any further anthelminths? is there any role of levamisole?

Expert Answer :

Answer Discussion :

D

Dfsa Ata

0

Nanazoxanid can be use

24 Days ago

S

Santosh R

0

ivermectin would be a better choice because it causes tonic paralysis and immobilses the round worms

24 Days ago

S

Santosh R

0

the best drug is piperazine the response will be dramatic.see if you can get it.ivermectin or pyrantel pamoate are alternative treatments

24 Days ago

D

DrAhemad Pothiawala

0

yes. a single dose of levamisole may help in expelling remaining worms

24 Days ago

D

doctor imran

0

advice

24 Days ago

Answer 1

The fact that the child passes roundworms from his mouth with the fact that he is malnourished tells us that he must be harboring a high worm load.
In such cases, the initial choice of antihelminths should be the one that can paralyze the worm followed by the one that stops its Glucose uptake.
This is done primarily so that if drugs like Mebendazole oral bendazole is used in cases of high worm load the helminth starts invading the biliary tract, comes from the mouth, etc.
hence a paralysing agent can be used.
In this context I would suggest you use pyrantel pamoate{available as nemocid syrup} @ 11mg/kg/day single night dose (as for ascaris, or 3 days for hookworm) followed the next day with a single dose of albendazole. That should take care of the worm load.
{ideally even only Pyrantel Pamoate works but it's better to use 2 drugs simultaneously one after the other}

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