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Eficacia de los medicamentos actuales contra las infecciones de helmintos transmitidas por el suelo: revisión
Jennifer Keiser1, Jürg Utzinger
1Department of Medical Parasitology and Infection Biology, Swiss Tropical Institute, PO Box, CH-4002 Basel, Switzerland. jennifer.keiser@unibas.ch
JAMA
|April 24, 2008
Resumen
Las dosis únicas de albendazol, mebendazol y pirantel pamoato son efectivas contra el Ascaris lumbricoides. Sin embargo, los tratamientos actuales son insatisfactorios para Trichuris trichiura, lo que pone de relieve la necesidad urgente de nuevos anthelminticos.
Área de la Ciencia:
- Parasitología Médica.
- Enfermedades infecciosas Enfermedades infecciosas.
- Farmacología Farmacología.
Sus antecedentes:
- Los helmintos transmitidos por el suelo infectan a más de una cuarta parte de la población mundial.
- La quimioterapia preventiva se basa en cuatro medicamentos principales: el albendazol, el mebendazol, el levamisole y el pirantel pamoato.
Objetivo del estudio:
- Para evaluar la eficacia de una dosis única de albendazol oral, mebendazol, levamisole y pirantel pamoate. para evaluar la eficacia de una dosis única de albendazol oral, mebendazol, levamisole y pyrantel pamoate. para evaluar la eficacia de una dosis única de albendazol oral, mebendazol, levamisole y pyrantel pamoate. para evaluar la eficacia de una dosis única de albendazol oral y pyrantel pamoate.
- Para evaluar la efectividad del tratamiento contra Ascaris lumbricoides, el gusano de gancho y Trichuris trichiura.
Principales métodos:
- Búsqueda sistemática de la literatura de las principales bases de datos (PubMed, Web of Science, etc.) para obtener más información. desde 1960 hasta el 2007.
- La inclusión de 20 ensayos controlados aleatorios.
- Metaanálisis de las tasas de curación y las tasas de reducción de huevos utilizando un modelo de efectos aleatorios.
Principales resultados:
- El albendazol, el mebendazol y el pirantel pamoato demostraron altas tasas de curación (88-95%) para el Ascaris lumbricoides.
- El albendazol (72%) fue más eficaz que el mebendazol (15%) y el pirantel pamoato (31%) contra el anquilostomo.
- Las tasas de curación para Trichuris trichiura fueron bajas (28-36%) para albendazol y mebendazol.
Conclusiones:
- Las dosis únicas de albendazol, mebendazol y pirantel pamoato son muy efectivas contra el Ascaris lumbricoides.
- El albendazol muestra una eficacia superior para la infección por anquilostomas en comparación con el mebendazol y el pirantel pamoato.
- Los antihelmínticos actuales de dosis única son inadecuados para el tratamiento de Trichuris trichiura, lo que hace necesario el desarrollo de nuevos medicamentos.
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