MANAGEMENT AND THERAPY


Treatment involves surgery for lesion if accessible. There are also two categories of drugs, Antihelminthic agents and Glucocorticoids, that may be used for T.multiceps, as well as all other Taeniid infections. Chemotherapy treatment is not available.

Drug Category: Antihelminthic agents- Praziquantel is considered the drug of choice. Niclosamide also can be used. Both are administered as a single-dose therapy.

Drug Name:Praziquantel- The drug of choice for Taeniid infections. Increases cell membrane permeability in susceptible worms, resulting in loss of intracellular calcium, massive contractions, and paralysis of musculature.
Adult Dose:5-10 mg/kg
Precautions:Mild and transient adverse effects include dizziness, headache, abdominal pain, fatigue, malaise, and limb pain.

Drug NameNiclosamide- Acts by causing necrosis of the head and adjoining segments of the tapeworm. The worm loses its hold and is eliminated in pieces or intact with the feces.
Adult Dose:Available as 500-mg tab.
Precautions:Most adverse effects are mild and transient including vomiting, nausea, and abdominal distress.

Drug Name:Albendazole- Decreases ATP production in worm, causing energy depletion, immobilization, finally death.
Adult Dose:15 mg/kg
Precautions:Abdominal pain, nausea, vomiting, diarrhea, dizziness, vertigo, fever, increased intracranial pressure, and alopecia may occur.


Drug Category: Glucocorticoids-Useful in cases of increased intracranial pressure resulting from antihelminthic-induced cyst death and resultant inflammation.

Drug Name:Dexamethasone-An adrenocortical steroid. Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability.
Adult Dose:1-2 mg/kg initially; followed by 1-1.5 mg/kg for 2-3 days.
Precautions:Increases risk of multiple complications, including severe infections.