Praziquantel in prevention of complicated echinococcosis relapses
Abstract number: 1733_45
Dautovic S., Koluder N., Ferhatovic M., Mostarac N., Kapisazovic S., Tanovic H., Mesic A., Gojak R.
Human echinococcosis is a large therapeutical problem in all farmer regions of the world. It is an antropozoonosis usually coincidentally diagnosed by radiological methods. It can affect all organs, but most frequently it affects liver. Even today this disease can cause serious disability, when it is lately diagnosed, disseminated or when relapses occur. When the cyst is small and accessible, total cyst and pericyst excision is the only proper therapeutical procedure. Solitaire cyst can be resolved by PAIR method. In complicated cases combined conservative (albendazol)-surgical treatment is recommended (WHO). Relapses rates are usually between 4 and 37%.
Objectives: To investigate the frequency of postoperative relapses in our material and to investigate praziquantel efficiency in combined conservative-surgical treatment.
Methods: This was an open prospective-retrospective study, started in June, 1996. All patients with complicated or large echinococcus cysts, treated at The Clinic for Infectious Diseases and at The Clinic for Abdominal Surgery, Clinical Centre University of Sarajevo, in the period of 1st June, 1996 to 1st June, 2006, were included. Praziquantel was used in doses of 2550 mg/kg for 14 days with corticosteroids as an adjuvant therapy. All patients were monitored clinically, so as by radiological and serological tests after one, three, six and than every 12 months.
Results: In this period of time 70 patients were treated by combined conservative-surgical treatment, mean age of 34.7 (465). There were 42 patients suffered from primary and 28 patients with echinococcosis relapses. In 53 cases evacuation of large cysts was done and 17 patients had cyst rupture. Our results signify that there were 12.5% of recidives in the group of patients which was treated only by surgical treatment in this period. In the group of patients treated by combined treatment there were no relapses, if praziquantel antihelmintic treatment was used in pre and postoperative period. Using praziquantel 10 days after cyst rupture was not effective.
Conclusions: Human echinococcosis is a large public-health problem in Bosnia and Herzegovina. Postoperative relapses in complicated cases occur at rate of 12.5%. After combined treatment, using praziquantel, there were no cases of relapses. Praziquantel can be an antihelmintic of choice in prevention of complicated echinococcosis relapses in combined treatment.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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