Treatment of the microfilaraemia of
asymptomatic brugian filariasis with single
doses of ivermectin, diethylcarbamazine or
albendazole, in various combinations
Several new chemotherapeutic tools are now available for the control of lymphatic filariasis. Combinations
of single doses of antifilarial drugs are generally superior to single drugs. The efficacy and safety of
albendazole in combination with diethylcarbamazinc (DEC) or ivermectin, for the treatment of Brugia
malayi infection, were investigated, for the first time, in an open, hospital-based study. Fifty-one
asymptomatic microfilaraemics (with 108-4034 microfilariae/ml; median = 531) of both sexes and aged
14-70 years were randomly allocated to receive single-dose treatments of ivermectin (200 μg/kg) with
diethylcarbamazine (DEC; 6 mg/kg), ivermectin (200 μg/kg) with albendazole (400 mg), DEC (6 mg/kg)
with albendazole (400 mg), or albendazole (400 mg) alone. Albendazole alone had no effect on the
microfilarial levels at the 1-year follow-up but both groups given DEC had significantly lower microfilaraemias
( P < 0.015 and P < 0.02) than that given ivermectin with albendazole. Overall, 47%-64%
of those given DEC but only 14% of those given ivermectin with albendazole appeared to be
amicrofilaraemic 1 year post-treatment. The adverse reactions seen in the study were mild, transient and
qualitatively similar to those seen earlier with ivermectin and DEC. The combination of DEC and
albendazole, both well tested drugs, offers a new option for countries such as India where there is no
onchocerciasis or loiasis and where ivermectin may not be immediately available. The direct and indirect
effects of albendazole on intestinal helminths would be additional benefits