Mehdi Keshmiri, MD(*); H Baharvahdat, MD; S H Fattahi, MD; B Davachi, MD; H Bradaran, MD; R H Dabiri, MD and F Rajzbzadeh, MD. Mashad University of Medical Sciences - Ghaem Hospital.
PURPOSE: Echinococcus granulosus can be a multiorgan infection whose response to medical treatment remains contraversial. There are uncontrolled studies showing that albendazole can be effective in its treatment; but there are also reports of spontaneous resolutions. Therefore, we undertook a placebo controlled triple blind parallel randomised study evaluating the effecto of albendazole on hydatid cysts.
METHODS: Twenty-nine patients with 240 cysts were entered into the study. One hundred seventy two cysts received albendazole 400 mg bid in 3 cycles of 6 weeks with 2 weeks between cycles and 31 cysts recieved placebo. During treatment clinical, biochemical and imaging evaluation were carried out.
RESULTS: In the treatment arm 134 cysts showed improvement or cure compared to 4 in the placebo group (p=0.00). Eighteen of 22 patients (82%) in the treatment arm showed either cure (8 patients) or improvement (10 patients); while in the placebo group only one of seven(14%) showed spontaneous improvement but no cure. Some patients with liver cysts after treatment showed increasing herterogenousity and density suggestive of inactive cysts. Patients with larger cysts and those with pulmonary involvement were better responders while age and gender had no effect on outcome.
CONCLUSION: The observed results are encouraging showing albendazole had good effect on hydatid cysts and should be offered to patients before surgical treatment is considered.
COPYRIGHT 2000 American College of Chest Physicians
COPYRIGHT 2001 Gale Group
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