Cysticercosis, drugs used

Albendazole, a broad-spectrum oral antihelminthic, is the drug of choice and is approved in the USA for treatment of hydatid disease and cysticercosis. It is also used in the treatment of pinworm and hookworm infections, ascariasis, trichuriasis, and strongyloidiasis. 

Praziquantel is effective in the treatment of schistosome infections of all species and most other trematode and cestode infections, including cysticercosis. The drug s safety and effectiveness as a single oral dose have also made it useful in mass treatment of several infections. 

Controversies in the management of neurocysticercosis have been described (10-12). The management of the neurological complications of cysticercosis and in particular the role of antiparasitic drugs are issues of debate. It is commonly believed that the use of antiparasitic drugs and steroids should be individualized, based on the presence of active or inactive disease, the location of the cysts, and the presence or absence of complications such as hydrocephalus. 

This drug was used prior to the availability of niclosamide and is considered less satisfactory for the treatment of tapeworms than niclosamide (24). It causes more side effects and produces severe nausea. Quinacrine, however, is preferred by some clinicians for the treatment of Taenia solium infection because, unlike niclosamide, it expels the worms intact, thus reducing the theoretical risk of cysticercosis (25). 

Praziquantel is the drug of first choice for infections caused by the Oriental liver fluke and by the fish tapeworm. Both types of infection are transmitted mainly via the consumption of raw fish. Niclosamide is one of two dmgs of choice for fish tapeworm infections (with praziquantel), but it is not active against Clonorchis sinensis. Albendazole is not effective in fish tapeworm infections but is useful in the pork tapeworm larval stage (cysticercosis). The answer is (E). 

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