ABSTRACT

Introduction

The only drug effective against the infection caused by Fasciola hepatica or F. gigantica is triclabendazole (TCBZ), recommended by the WHO and recently approved by the FDA. Here, we describe the evolution of TCBZ regimens and the emergence of TCBZ failure to Fasciola infection.

Areas covered

The present review focuses on the evidence of TCBZ for the treatment of fascioliasis. For acute fascioliasis, there is a lack of studies to measure the presence of eggs of Fasciola in stool samples on the follow-up after initial TCBZ treatment. For chronic fascioliasis, WHO recommends a single oral dose of TCBZ 10 mg/kg whereas CDC recommends two doses of TCBZ 10 mg/kg 12 h apart. Incremental number of treatment failures have been documented worldwide. There are currently no therapeutic alternatives for the treatment of fascioliasis in humans.

Expert opinion

Most cases of human fascioliasis are successfully treated with TCBZ, but some continue excreting eggs in the stools despite 1–2 standard of care regimens of TCBZ. A precise regimen is unclear for those patients who fail the initial treatment with TCBZ. Further clinical trials are needed to address the possible TCBZ emerging resistance.

中文翻译：

---

三氯苯达唑用于治疗人片吸虫病和治疗失败的威胁

摘要

介绍

抗感染引起的有效的唯一药物肝片吸虫或F.吸虫是三氯苯达唑（TCBZ），由世卫组织建议，最近被FDA批准。在这里，我们描述了 TCBZ 方案的演变和 TCBZ 失败对片形吸虫感染的出现。

覆盖区域

本综述重点关注 TCBZ 治疗片形吸虫病的证据。对于急性片形吸虫病，在初始 TCBZ 治疗后的随访中，缺乏测量粪便样本中片形吸虫卵存在的研究。对于慢性片吸虫病，WHO 建议单次口服 TCBZ 10 mg/kg，而 CDC 建议两剂 TCBZ 10 mg/kg，间隔 12 小时。世界范围内已经记录了治疗失败的增加数量。目前没有治疗人类片形吸虫病的替代疗法。

专家意见

大多数人片吸虫病病例都用 TCBZ 成功治疗，但尽管有 1-2 个标准的 TCBZ 护理方案，但仍有一些人继续通过粪便排出虫卵。对于 TCBZ 初始治疗失败的患者，确切的治疗方案尚不清楚。需要进一步的临床试验来解决可能出现的 TCBZ 耐药性问题。