A single dose of doxycycline in combination with diethylcarbamazine for treatment of bancroftian filariasis

Sanprasert, V.; Sujariyakul, A.; Nuchprayoon, S.

Southeast Asian Journal of Tropical Medicine and Public Health 41(4): 800-812

2010


ISSN/ISBN: 0125-1562
PMID: 21073054
Document Number: 10635
Standard treatment of lymphatic filariasis with diethylcarbamazine (DEC) is associated with systemic adverse reactions, thought to be due to the release of microfilariae material and Wolbachia endosymbiotic bacteria into the blood. Combination treatments with doxycycline for 3-8 weeks are more effective than standard treatment. However, long-term use of antibiotics may contribute to drug resistance and are not practical for use in remote areas. We assessed whether a single dose of doxycycline combined with the standard DEC regimen would reduce the incidence and severity of adverse reactions and increase the efficacy of standard treatment. Forty-four subjects from Tak Province were recruited into the randomized double-blind clinical trial study: 25 received DEC (300 mg) combined with a placebo, and 19 received DEC (300 mg) combined with doxycycline (200 mg). The incidences of adverse reactions to standard treatment were lower in the doxycycline group (45.5%) than in the placebo group (58.8%). Severe reactions occurred only in the placebo group (3 of 25 subjects). The severity of adverse reactions was significantly lower in the doxycycline group (mean score 0.45) than in the placebo group (mean score 1.17). The levels of IL-6 and Wolbachia DNA in the plasma were significantly lower in the doxycycline group. The filarial antigen levels were significantly lower in the doxycycline group at months 6 after treatment.

Document emailed within 1 workday
Secure & encrypted payments

A single dose of doxycycline in combination with diethylcarbamazine for treatment of bancroftian filariasis