Therapeutic target
- Cyst inactivation
Therapy recommendation
- Alveolar echinococcosis (AE).
- If surgical resection is not possible: lifelong therapy with with the benzimidazoles albendazole or mebendazole (anthelmintics/drugs against worm diseases) Close follow-up; if necessary, later surgical curative resection (surgical removal aimed at curing the patient) if the response to drug therapy is good.
- Cystic Echinococcosis (CE).
- Primary hepatic cysts
- CL, CE 4, CE 5: observe and monitor (Wait and Watch).
- CE 1,2,3: Invasive imaging procedures (percutaneous aspiration, scolicide, instillation, re-aspiration = PAIR) or surgical resection under albendazole coverage (see below “Surgical Therapy“).
- Secondary echinococcosis (spread of daughter cysts outside the mother cyst): therapy with albendazole (benzimidazole).
- Primary hepatic cysts
- See also under “Further therapy”.
Legend
- Wg. CL, CE1-5 see under classification.
Active ingredients (main indication)
Benzimidazoles (anthelmintic).
- Mode of action: vermicidal
- Dosage information:
- In alveolar echinococcosis lifelong; therapeutic serum levels must be adjusted and monitored in the process.
- For cystic echinococcosis perioperatively for up to four weeks/three months.
- Side effects: Headache, dizziness, gastrointestinal (nausea, abdominal pain), liver enzymes ↑ (albendazole hepatitis), fever, hair loss; bone marrow suppression.
- Initially 1, then 3-monthly checks of liver enzymes and blood counts!