Helminths of the gut (worms)

Information is taken from 'Manson's Tropical Diseases' (1996) Editor Gordon C Cook. Publisher WB Saunders Company Ltd. ISBN 0-7020-1764-7 and see also the British National Formulary for contra-indications and side-effects.

ENTEROBIASIS (Threadworm)
Albendazole is the treatment of choice as a single dose of 400mg or 10-14mg/kg for children.
Alternatives are mebendazole as a single dose of 100mg which is available without a doctors prescription or pyrantel pamoate (Combantrin) 10mg/kg given as a single oral dose and repeated every 6 weeks if necessary.
Treatment in pregnancy can be a problem since the manufacturers advise avoiding these drugs in pregnancy.
The basis of this with mebendazole is toxicity in animal studies only (See British National Formulary). Therefore sometimes, with the patients agreement, mebendazole is used after the first trimester if symptoms are severe.

STRONGYLOIDES (Whipworms)
Mebendazole is the drug of choice with a single oral dose of 600mg or alternatively 100mg twice daily for 3 days.
Albendazole with a single dose of 400mg is an alternative.

ASCARIS LUMBRICOIDES (Round worms)
Albendazole with a single dose of 400mg for those over 5 years of age or 200mg as a single dose for children aged 2-4 years.
Mebendazole 100mg twice daily for one day only.
Levamisole with a single dose of 5 mg/kg body weight.
Pyrantel pamoate with a single dose of 10 mg/kg.

ANCYLOSTOMIASIS (Hookworms)
Albendazole with a single dose of 400mg for those over 5 years of age or 200mg as a single dose for children aged 2-4 years.
Mebendazole 100mg twice daily for 3 days.
Pyrantel pamoate with a single dose of 10 mg/kg.

CUTANEOUS LARVA MIGRANS
Thiabendazole 25mg/kg twice daily for 5 days. A repeat may be necessary.
Topical thiabendazole can be used and is made by grinding up a 0.5mg tablet with 5g of petroleum jelly and applying liberally for 5 days.
Mebendazole is an alternative at 100mg three times daily for 7 days.