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Int J Parasitol Drugs Drug Resist. 2018 Aug;8(2):329-330. doi: 10.1016/j.ijpddr.2018.05.004. Epub 2018 May 18.

Comment on "The optimal timing of post-treatment sampling for the assessment of anthelminthic drug efficacy against Ascaris infections in humans".

Author information

1
Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany. Electronic address: juergen.kruecken@fu-berlin.de.
2
Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany.
3
University Teaching Hospital of Butare, University of Rwanda, Butare, Rwanda.
4
Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
5
Mycotic and Parasitic Agents and Mycobacteria, Department of Infectious Diseases, Robert Koch-Institute, Berlin, Germany.
6
Dawbuts, 9 Mitchell St, Camden, NSW, 2750 Australia.

Abstract

A recent publication by Levecke et al. (Int. J. Parasitol, 2018, 8, 67-69) provides important insights into the kinetics of worm expulsion from humans following treatment with albendazole. This is an important aspect of determining the optimal time-point for post treatment sampling to examine anthelmintic drug efficacy. The authors conclude that for the determination of drug efficacy against Ascaris, samples should be taken not before day 14 and recommend a period between days 14 and 21. Using this recommendation, they conclude that previous data (Krücken et al., 2017; Int. J. Parasitol, 7, 262-271) showing a reduction of egg shedding by 75.4% in schoolchildren in Rwanda and our conclusions from these data should be interpreted with caution. In reply to this, we would like to indicate that the very low efficacy of 0% in one school and 52-56% in three other schools, while the drug was fully efficient in other schools, cannot simply be explained by the time point of sampling. Moreover, there was no correlation between the sampling day and albendazole efficacy. We would also like to indicate that we very carefully interpreted our data and, for example, nowhere claimed that we found anthelmintic resistance. Rather, we stated that our data indicated that benzimidazole resistance may be suspected in the study population. We strongly agree that the data presented by Levecke et al. suggests that recommendations for efficacy testing of anthelmintic drugs should be revised.

PMID:
29800794
PMCID:
PMC6039316
DOI:
10.1016/j.ijpddr.2018.05.004
[Indexed for MEDLINE]
Free PMC Article

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