Treatment of Intestinal Worms

Introduction to Treatment

The American Society of Tropical Medicine and Hygiene recommends albendazole 400 mg orally as a single dose as the first-line treatment for most intestinal worm infections, including hookworm, roundworm, and pinworm 1, 2

For hookworm infections, the Centers for Disease Control and Prevention recommends albendazole 400 mg PO daily for 3 days 1
For severe hookworm disease with anemia, the World Health Organization suggests adding prednisolone 40-60 mg once daily 1
The American College of Gastroenterology recommends treating all household contacts simultaneously with albendazole 400 mg PO as a single dose for pinworm infections due to high contagiousness 2
For whipworm infections, the Infectious Diseases Society of America recommends mebendazole 100 mg PO twice daily PLUS ivermectin 200 μg/kg once daily for 3 days 1
The National Institutes of Health recommends albendazole 400 mg PO twice daily for 21 days with monitoring of liver function and complete blood count for threadworm/strongyloides infections 1
The World Health Organization advises excluding Loa loa infection before giving ivermectin in patients from endemic regions to prevent severe encephalopathy 2

For patients from endemic areas with high pretest probability but negative stool tests, the American Society of Tropical Medicine and Hygiene suggests giving albendazole 400 mg PLUS ivermectin 200 μg/kg as a single combined dose 2, 3

The Centers for Disease Control and Prevention recommends screening for Loa loa before ivermectin in patients from Central/West Africa 2
The Infectious Diseases Society of America advises seeking specialist advice for immunocompromised patients, children aged 12-24 months, and severe disease requiring intensive care management 1, 2

The World Health Organization recommends hand hygiene with soap before eating and after defecation, wearing shoes in endemic areas, and treating household contacts for highly contagious infections like pinworm 2, 3

The American Society of Clinical Pathologists recommends concentrated stool microscopy as first-line for most helminths, with fecal PCR offering higher sensitivity when available 1, 2
The National Institutes of Health suggests using serology and specialized stool techniques for Strongyloides due to low microscopy sensitivity 2