4 Antiparasitic Medications
Review organism-specific antiparasitic treatment, medication safety, monitoring, and prevention advice for common protozoal and helminthic infections.
Choosing treatment by infection
Treatment decisions depend on the organism, infection site, patient factors, and current clinical guidance. Protozoal infections may require agents such as nitroimidazoles or antimalarials, while helminth infections may require medications such as albendazole, ivermectin, or praziquantel. Medication choice is specific to the infection and clinical context; antiparasitic drugs are not interchangeable.
and fluid replacement
Diarrhea during can cause dehydration, so drink fluids during recovery. Several medicines can treat Giardia, but selection depends on the patient and clinical context.
Pinworm treatment and prevention
For treated with mebendazole, give a second dose 2 weeks after the first as directed because the medication kills worms but not their eggs. Treat household members and caregivers at the same time when advised. Careful handwashing and laundering clothing and bedding help reduce reinfection.
Strongyloides and immunosuppression
Strongyloides infection can cause hyperinfection or disseminated disease when a person becomes immunosuppressed. Raise this risk with the prescriber before high-dose corticosteroids; screening or treatment should be considered in appropriate patients before immunosuppression. Ivermectin is first-line treatment in CDC guidance.
Reducing pyrimethamine toxicity
Pyrimethamine, used with sulfadiazine for , can suppress bone marrow. Leucovorin (folinic acid) helps reduce this toxicity, and blood counts should be monitored as clinically directed.
Taking praziquantel safely
Take praziquantel tablets with water during meals. Common adverse effects include headache, dizziness, nausea, and abdominal discomfort. Relevant medication interactions and patient-specific risks should be considered.
G6PD testing before relapse-prevention treatment
Before starting to prevent relapse of Plasmodium vivax , obtain a quantitative G6PD test. can cause serious hemolysis in people with ; quantitative testing is also required before prescribing tafenoquine.
treatment and monitoring
treatment depends on species, clinical severity, and likely drug susceptibility. Patients with P. falciparum, P. knowlesi, or of unknown species should initially be hospitalized and monitored with daily blood smears. A falling fever alone does not confirm that the parasite has been cleared. After intravenous artesunate for severe , a complete oral antimalarial course is required.
and partner treatment
To reduce reinfection and transmission from , the patient and partner or partners should complete treatment, and sexual activity should wait until symptoms have resolved. Concurrent treatment of partners is important.
Following treatment and recognizing serious reactions
Complete the prescribed regimen and follow the prevention advice specific to the infection. Expected adverse effects vary by medication, so follow the instructions for the prescribed drug. Report severe or worsening symptoms, a serious rash, breathing difficulty, or other signs of an allergic reaction promptly for clinical assessment; mild, brief effects may differ by medication.