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PubMed1992

Efficacy of ivermectin against Strongyloides stercoralis in humans.

Okinawa Prefecture is an endemic area of Strongyloides stercoralis infection. Since treatment of this infection remains unsatisfactory, we evaluated the efficacy of ivermectin. Twenty-three patients were treated with a single oral dose of ivermectin (mean +/- SD, 105.5 +/- 20.8 mcg/kg of body weight), followed by a second dose two weeks later. The rate of cure was 85.7% at 2 weeks after the first treatment, and 90.5% at 2 weeks after the second treatment. Side effects occurred in 2 patients (8.7%), but they were mild and transient. The results indicate that ivermectin might be useful and relatively safe for the therapy of Strongyloides stercoralis infection as an alternative to thiabendazole or mebendazole.

Aged↗
PubMed2002

Frequency of the mutant MDR1 allele associated with ivermectin sensitivity in a sample population of collies from the northwestern United States.

OBJECTIVE: To determine the frequency of the MDR1 gene mutation (polymorphism) associated with ivermectin sensitivity in a sample population of Collies in Washington and Idaho. ANIMALS: 40 healthy client-owned Collies. PROCEDURE: A blood sample (8 ml) was collected from each dog and used for RNA extraction. Reverse transcriptase was used to generate MDR1 cDNA. Polymerase chain reaction (PCR) primers were designed to amplify a 1,061-base pair region of the MDR1 gene. The PCR products were sequenced to determine whether the Collies had 0, 1, or 2 mutant alleles. Pedigrees of some dogs were available for analysis to determine relatedness of affected dogs. RESULTS: Of the 40 Collies, 9 (22%) were homozygous for the normal allele (normal), 17 (42%) were heterozygous (carrier), and 14 (35%) were homozygous for the mutant allele (affected). Pedigree analysis revealed that some, but not all, affected dogs were related to each other within the 4 most recent generations. CONCLUSIONS AND CLINICAL RELEVANCE: A high percentage of a sample population of Collies in Washington and Idaho are affected or carriers of the mutant MDR1 allele associated with ivermectin sensitivity. A similar frequency of this mutation may be detected in dogs from other geographic areas. Pharmacologic treatment with ivermectin, loperamide, vincristine, and other drugs that are substrates of P-glycoprotein, the MDR1 gene product, may result in neurologic toxicosis in a high percentage of Collies.

Alleles↗
PubMed2003

Evaluation of the safety of ivermectin-praziquantel administered orally to pregnant mares.

OBJECTIVE: To evaluate the safety of an orally administered ivermectin and praziquantel paste with regard to variables associated with clinical findings, parturition, lactation, maternal care, and neonate viability in pregnant mares. ANIMALS: 40 pregnant mares. PROCEDURE: Mares were randomly allocated into treatment (n = 20) and control (20) groups and administered a placebo or 3 times the therapeutic dosage of ivermectin (0.6 mg/kg) and praziquantel (4.5 mg/kg) at 14-day intervals until parturition. Physical examinations were performed on mares and their foals after parturition (on postpartum days 30, 60, and 90) to identify any drug-related effects. As an aid in assessing general health, hematologic and serum biochemical analyses were performed monthly on the mares. RESULTS: In blood constituents, minor alterations that were not biologically important were observed. Reproductive performance was not affected by the unusual treatment duration or high dosage, although the drugs were administered during a crucial period of equine embryonic development (30 to 60 days). Neither adverse effects on mares nor abortions occurred. Follow-up evaluations of the foals for a 3-month period did not detect any abnormalities. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of the ivermectin-praziquantel paste appears to be safe in pregnant mares and their foals.

Administration, Oral↗
PubMed2006

A fenbendazole oral drench in addition to an ivermectin pour-on reduces parasite burden and improves feedlot and carcass performance of finishing heifers compared with endectocides alone.

Two studies utilizing 1,862 yearling heifers were conducted to determine the effects of a fenbendazole oral drench in addition to an ivermectin pour-on (SG+IVPO), compared with an ivermectin pour-on (IVPO) or a doramectin injectable (DMX) alone, on parasite burden, feedlot performance, and carcass merit of feedlot cattle. In the first study, heifers receiving the SG+IVPO had fewer (P = 0.02) cattle retreated for disease and 73% fewer (P = 0.06) worm eggs per fecal sample 98 d after treatment than heifers treated with IVPO. Heifers treated with SG+IVPO consumed more DM, had greater ADG, were heavier at slaughter, and had heavier carcasses than IVPO-treated heifers (P < 0.05). Heifers treated with SG+IVPO also had more (P = 0.07) carcasses grading USDA Prime or Choice than IVPO-treated heifers. In the second study, heifers treated with SG+IVPO had fewer (P < 0.01) worm eggs per fecal sample 35 d after treatment and had fewer numbers of adult and larval Cooperia and Trichostrongylus spp. in the small intestine at slaughter (P < 0.10) compared with heifers treated with DMX. Heifers treated with SG+IVPO consumed more DM, were heavier at slaughter, and had heavier carcasses than DMX-treated heifers (P < 0.01). The SG+IVPO-treated heifers also had greater ADG (P < 0.10). The broad-spectrum effectiveness of a combination of a fenbendazole oral drench and an ivermectin pour-on reduced parasite burden and increased feed intake, ADG, and carcass weight in feedlot heifers compared with treatment with an endectocide alone.

Administration, Oral↗
PubMed1990

Use of ivermectin to control the lesser mealworm (Coleoptera: Tenebrionidae) in a simulated poultry broiler house.

Broiler chickens were fed ivermectin at a level of 2 ppm for 5 wk to determine its efficacy against the lesser mealworm, Alphitobius diaperinus. This treatment essentially eliminated lesser mealworm larvae; no ivermectin residues were found in the livers of the treated chickens, even without a withdrawal period. However, the feeding of ivermectin may reduce body weights body weight gain and feed efficiency at older ages.

Age Factors↗
PubMed2005

Efficacy of parenteral administration of ivermectin in the control of strongylidosis in donkeys.

Investigations into the efficacy of parenteral ivermectin (Pandex) administration for strongylidosis control in donkeys were carried out. The preparation was applied subcutaneously at a dose of 0.2 mg/kg (1 ml/50 kg body weight). One day prior to the treatment and 14 days post-treatment, individual coprological samples were obtained for faecal nematode egg counts and larval culture. The study was performed on 263 donkeys originating from different regions of Bulgaria. Prior to the treatment and 20 days after that, blood samples were obtained from 64 previously infected animals for monitoring of changes in eosinophil leukocyte counts. The subcutaneous application of ivermectin had an efficacy of 96% in terms of reduction of faecal egg counts. In 92.2% of infected donkeys, a complete reduction of faecal eggs count occurred (0 eggs per gram of faeces epg), whereas in the remaining 7.8% of the infected donkeys, the egg counts were reduced by 72%. The reduction in faecal egg counts did not result in changes in eosinophil counts. The results obtained as well as the lack of local changes after the subcutaneous application of ivermectin in donkeys allow us to recommend its use for control of strongyles in donkeys.

Animals↗
PubMed1989

Ivermectin for human strongyloidiasis and other intestinal helminths.

Since ivermectin, a mixture of 2 closely related macrocyclic lactones, has proven highly effective against animal intestinal nematodes, trials were undertaken to determine its efficacy against human intestinal nematodes. We tested 110 patients with strongyloidiasis and 90 with enterobiasis; many had other intercurrent intestinal nematode infections. Stool examinations were done before and after patients were given a single dose of oral ivermectin capsules (50, 100, 150, or 200 micrograms/kg body wt); 55 recipients of 100 or 200 micrograms/kg doses received a second identical dose the next day. Kato and saline smears, ethyl acetate concentration, modified Baermann's technique, and Harada-Mori cultures were repeated; cure was defined as complete absence of eggs and/or larvae from stools tested 30 days after dosing. Ivermectin was well tolerated. Overall cure rates at all doses 30 days after therapy averaged 88% for strongyloidiasis, 100% for ascariasis, 85% for trichuriasis, and 85% for enterobiasis. Ancylostoma duodenale and Necator americanus were little affected.

Adolescent↗
PubMed1989

Ivermectin treatment of patients with severe ocular onchocerciasis.

The treatment of onchocerciasis with diethylcarbamazine and suramin is associated with an exacerbation of ocular disease. This occurs more frequently in patients with severe onchocercal ocular disease. We assessed ocular changes following ivermectin treatment in 39 patients with severe ocular onchocerciasis. Patients were treated with 100, 150, or 200 micrograms/kg of ivermectin at either 1 or 2 year intervals and followed for 3 years. There was no evidence for an acute exacerbation of either anterior or posterior segment eye disease, and there was a marked improvement in ocular status in the group as a whole. There was a significant decrease in onchocercal involvement which was maintained for at least 3 years. Annual treatment with ivermectin can be used safely in patients with severe ocular disease and is beneficial over a prolonged period of time.

Adolescent↗
PubMed1990

Effect of mass treatment of a human population with ivermectin on transmission of Onchocerca volvulus by Simulium yahense in Liberia, West Africa.

The impact of mass treatment with ivermectin on the intensity of Onchocerca volvulus transmission by the black fly (Simulium yahense) was evaluated on the Liberian Agricultural Company rubber plantation in Liberia, West Africa. The adult pre-treatment prevalence of onchocerciasis was greater than 80%, and the average intensity of infection was 5.35 mf/mg of skin. The drug was administered at 2 annual intervals, reaching 58-60% of the approximately 14,000 people living in 73 camps. Landing/biting catches of black flies made in central and peripheral plantation zones indicated similar fly activity before and after ivermectin treatment (man hr index of 2.1 and 2.4 within the plantation, and 10 and 10.9 outside the plantation, respectively). The number of infected flies with developing larvae (L1, L2, L3 stages) of O. volvulus in treated areas was reduced by 93.4-95%; the number of infective flies with L3 larvae was reduced by 81.7-89.3%. Parasite loads of infected (L1, L2) and infective flies (L3 stages only) outside the plantation also decreased by 86.8% and 80%, respectively. Monthly transmission potential (MTP) showed a similar decrease: from 22.9 to 5.8 (74.6% reduction) in the treated area, and from 210 to 158.8 (24.4% reduction) in untreated areas. Mass treatment with ivermectin efficiently controlled, and at least temporarily interrupted, transmission of Onchocerca volvulus by black fly vectors.

Animals↗
PubMed1993

Treatment of subperiodic Brugia malayi infection with a single dose of ivermectin.

A clinical trial on the efficacy of a single oral dose of ivermectin at 20, 50, 100, and 200 micrograms/kg was carried out in 40 subjects with subperiodic Brugia malayi microfilaremia. There was no significant difference in the clearance of microfilaremia in the four treatment groups, and the lowest geometric mean microfilarial count (GMC) achieved in the 40 subjects was 8.8/ml or 8.3% of the initial count (106.1/ml), at two weeks post-treatment. The GMC started to increase at one month post-treatment and by six months was 22.2% of the initial GMC. Only 27.5%, 23.1%, 15.0%, and 18.9% of subjects were amicrofilaremic at two, four, 12, and 24 weeks post-treatment, respectively. Mild fever in 35% of the subjects was the primary side reaction and was more common in those with microfilarial counts > or = 500/ml (85.7%) than in those with counts < 500/ml (32%). The clearance of B. malayi microfilaremia by ivermectin was less rapid than that reported for Wuchereria bancrofti. The smaller number of side reactions encountered in the present study compared with those reported for bancroftian filariasis is probably related to the lower microfilarial density in the present subjects. Since ivermectin at a single oral dose of 20-200 micrograms/kg can reduce the GMC to less than 10% at two weeks and maintain it below 25% of the initial level even at six months post-treatment, it is recommended that the drug be seriously evaluated for use in the control of brugian filariasis.

Administration, Oral↗
PubMed1993

A community-based trial of ivermectin for onchocerciasis control in the forest of southwestern Cameroon: clinical and parasitologic findings after three treatments.

In the onchocerciasis-endemic rain forest area of the Rumpi Hills in southwestern Cameroon, a community-based trial of ivermectin, given either once or twice a year over a three-year period (1988-1991), confirmed that the drug is a potent microfilaricide. The side effects recorded following the first treatment were edema, fever, pruritus, generalized body pains and lymphadenitis. Following subsequent treatments, the same adverse reactions were recorded, but these were generally milder when compared with those of the first treatment. The prevalence of skin microfilaria (mf) was more reduced in zone two, in which treatment was given every six months (76.9% reduction at the end of one year) than in the zone one, in which treatment was given once a year (7.4% reduction). In both zones, the impact of the drug in reducing the intensity of infection was more significant than that for prevalence. Besides pruritus, other skin symptoms were not significantly modified by ivermectin treatment. Ivermectin reduced the prevalence of ocular mf as well as the mf load of the anterior chamber of the eye, resulting in improvement of certain eye lesions such as punctate keratitis, anterior uveitis, and papillary anomalies. There was also some improvement in visual acuity. The level of participation of the village populations was somewhat low, ranging from 52% to 66%, despite excitement over the drug's additional benefit of expelling intestinal round worms.

Animals↗
PubMed1998

Short- and long-term action of multiple doses of ivermectin on loiasis microfilaremia.

One hundred nine Gabonese patients infected with Loa loa microfilariae were treated with ivermectin (200 microg/kg of body weight) at the Parasitology, Mycology and Tropical Medicine Department (Faculte de Medecine et des Sciences de la Sante, Libreville, Gabon). Each was given one dose per month for six consecutive months. The peripheral blood microfilaria (mf) count before and after each dose showed an average decrease in the microfilaremia of 87.3% (short-term-single dose). An annual single-dose mass treatment with 200 microg/kg of ivermectin was sufficient to control the parasite in populations with low (< 400/ml) L. loa mf counts. One month after the sixth dose (short-term-multiple doses), the average microfilaremia rate had decreased by 99.2% compared with the initial infection (35 patients). Samples were taken from 28 patients one month after the first dose and one month after the sixth dose. The average mf count decreased by 96.4% after the first dose and by 99.6% after the sixth dose (average residual mf counts = 13.7 and 1.5 mf/ml, respectively). The mf count after the sixth dose was only 11.2% of the count after the first dose. The low mf count persisted for more than six months after the sixth treatment (long-term-multiple doses). Thus, mass treatment with multiple doses is more appropriate for areas where the blood mf count is very high. These results show that the number of the annual treatments used in mass chemotherapy with ivermectin can be adapted to each population to provide efficient protection.

Adolescent↗
PubMed2001

Community-based ivermectin therapy for onchocerciasis: comparison of three methods of dose assessment.

A new method of assessment based on mid-upper arm circumference (MUAC) is described for dosage adjustment for community-based ivermectin distribution. We studied 878 subjects eligible for ivermectin dosing in Awhum, Nigeria. In a previous preliminary study of 40 persons, MUAC (in cm) correlated with weight (kg) in the first 20 male (r = 0.97, r2 = 0.95, P < 0.0001) and the first 20 female subjects (r = 0.94, r2 = 0.88, P < 0.0001). We therefore studied the use of height, physical appearance, and MUAC for calculating the dose of ivermectin. The MUAC-based schedule underdosed only 4.1% of the population. The methods based on height underdosed 3.3% and 21.1%, and assignment based on physical appearance underdosed 10.2% of the population studied. This MUAC-based method (13-15 cm, 0.5 tablet; 16-20 cm, 1.0 tablet; 21-27 cm, 1.5 tablets; > or = 28 cm, 2.0 tablets) is more convenient and corresponds closely to dosing by weight. An adaptation of this method with reference to other prevalent tropical diseases and their respective drugs is therefore advocated.

Adult↗
PubMed2026

Comparative Effectiveness of Oral Ivermectin, 1% Permethrin Shampoo, and 4% Dimethicone Liquid Gel in Treatment of Pediculosis Capitis among School Children in Chachoengsao Province, Thailand.

Pediculosis capitis remains a persistent public health issue, especially in developing countries where resistance to standard neurotoxic pediculicides like permethrin is increasingly prevalent. This study aimed to compare the effectiveness of alternative treatment options against the standard care in a resource-limited setting. We conducted a single-blind randomized controlled trial involving three primary schools in Chachoengsao Province, Thailand (ClinicalTrials.gov: NCT06332872). Eighty-five female participants ages 6-13 years with active infestations were enrolled. Schools were randomly assigned to three treatment arms: 1) oral ivermectin (200 &#xb5;g/kg) on Days 0 and 7; 2) 1% permethrin shampoo on Days 0 and 7, or 3) 4% dimethicone liquid gel as a single dose on Day 0. The primary outcome was the cure rate, defined as the absence of live lice and viable nits upon clinical assessment on Day 9. Of the 66 participants included in the final per-protocol analysis, oral ivermectin achieved a cure rate of 95.5% (21/22), which was significantly higher than that of the 1% permethrin standard of care (37.0%; 10/27) and the 4% dimethicone physical suffocant (29.4%; 5/17) (P <0.001). Although dimethicone achieved high initial parasitic clearance on Day 0 (88.2%), a rapid reinfestation rate of 58.8% was observed by Day 9, indicating that a single-dose protocol may be clinically insufficient. Adverse events were mild and temporary across all groups. Oral ivermectin appears significantly more effective than both 1% permethrin and single-dose 4% dimethicone in this population. These findings suggest that permethrin resistance is clinically prevalent and relevant in this area.

Humans↗
PubMedDate not supplied

A proposed new therapeutic protocol for the treatment of canine mange with ivermectin.

Ivermectin was used orally for the treatment of generalized demodicosis or scabies in 222 dogs. The dose was increased gradually from 50 microg/kg body weight on day one, 100 microg/kg body weight on day two, 150 microg/kg body weight on day three, 200 microg/kg body weight on day four, to the final dose of 300 microg/kg body weight on day five. This dose was continued daily until resolution for demodicosis and given four times at seven-day intervals for scabies. Two patients developed clinical ivermectin toxicity after two and 10 days, respectively, and recovered once the drug was discontinued. A gradual increase of the ivermectin dose into the therapeutic range and thorough monitoring of patients during treatment are recommended when using this drug to treat patients with generalized demodicosis or scabies.

Administration, Oral↗
PubMed1993

Efficacy of in-feed formulation ivermectin against Psoroptes sp. in bighorn sheep.

Four Rocky Mountain bighorn sheep (Ovis canadensis canadensis) were experimentally inoculated with Psoroptes sp. of bighorn sheep origin by placing approximately 50 mites into each ear. Two sheep developed reproducing mite colonies and lesions consisting of alopecia, and exudative dermatitis with scabs on ears, face and neck. Three months after inoculation, all four sheep were treated with an in-feed formulation of ivermectin at a dosage of 1 mg/kg of body weight in a pelleted ration daily for seven consecutive days. Mites could not be detected on any of the sheep 1, 2, or 3 mo after treatment, and lesions on the affected sheep resolved within 6 to 8 wk after treatment. Thus, under these conditions, ivermectin was completely effective in eliminating the mites; it also was palatable and nontoxic. Use of ivermectin in pelleted feed for field treatment of psoroptic mange is encouraged.

Administration, Oral↗
PubMed1995

Efficacy of ivermectin pour-on against Ostertagia ostertagi infection and residues in the American bison, Bison bison.

Sixteen American bison, Bison bison, were artificially infected with 10(5) infective stage larvae of Ostertagia ostertagi on 21 April 1993. At 42 days post-infection eight bison were treated with 0.5% ivermectin pour-on (500 micrograms/kg bodyweight) and eight treated with the carrier only. Bison were necropsied 17 and 18 days post-treatment (21 and 22 June 1993, respectively). Mean (+/- SE) of 5,413 (+/- 1,716) adults and 565 (+/- 305) immature O. ostertagi were recovered at necropsy from bison treated with the carrier. No O. ostertagi were detected in bison treated with ivermectin pour-on. Based on the levels of the ivermectin marker metabolite in liver and adipose tissue 18 days post-treatment, the established bovine withdrawal time of 48 days appears adequate to insure that violative residues do not occur.

Adipose Tissue↗
PubMed1999

Ivermectin treatment of mansonellosis in Trinidad.

This study was conducted to determine the efficacy and long-term effects of an intervention programme based on a single dose of Ivermectin (6 mg) administered during a double-blind placebo study of 40 persons with Mansonella ozzardi infections in Blanchisseuse, Trinidad. After four years, ivermectin reduced microfilariae levels by 82.2%. Short- and long-term effectiveness of the drug is contingent upon the initial microfilariae levels of the patient. We conclude that a single dose of ivermectin reduces microfilariae densities and provides both short- and long-term reductions in M ozzardi microfilaraemia.

Adult↗