CHEMOTHERAPY OF HELMINTHIC INFECTIONS
Helminths (worms) are multicellular organisms that infect very large numbers of humans and cause a broad range of diseases. Over 1 billion people are infected with intestinal nematodes, and many millions are infected with filarial nematodes, flukes, and tape-worms. They are an even greater problem in domestic animals. Many drugs, which are directed against a number of different tar-gets, are available to treat helminthic infections. In many cases, especially in the developing world, the goal is control of infection, with elimination of most parasites controlling disease symptoms and decreasing the transmission of infection. In other cases, com-plete elimination of parasites is the goal of therapy, although this goal can be challenging with certain helminthic infections, because of both limited efficacy of drugs and frequent reinfection after therapy in endemic areas.
Table 53–1 lists the major helminthic infections and provides a guide to the drug of choice and alternative drugs for each infec-tion. In the text that follows, these drugs are arranged alphabeti-cally. In general, parasites should be identified before treatment is started.