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Combination Therapy With Albendazole and Praziquantel Versus Albendazole Alone in Children With Seizures and Single Lesion Neurocysticercosis: A Randomized, Placebo-Controlled Double Blind Trial

Kaur, Satvinder MD*; Singhi, Pratibha MD*; Singhi, Sunit MD*; Khandelwal, Niranjan MD†

Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31819073aa
Original Studies
Abstract

Background: A combination of albendazole and praziquantel was more effective than albendazole alone in destroying Taenia cysts in an animal model. There are no such studies in humans.

Objective: To evaluate the efficacy and safety of a combination of albendazole and praziquantel in children with seizures and single small enhancing computerized tomographic lesions.

Study Type: Prospective, interventional, randomized, placebo-controlled, double blind clinical trial at a tertiary hospital in North India.

Subjects: One hundred twelve children with seizures for <3 months and single lesion neurocysticercosis; 9 lost to follow-up.

Intervention: All children received albendazole (15 mg/kg/d) for 7 days with either praziquantel or placebo (75 mg/kg/d) for 1 day according to random allocation. Repeat CT scans were done after 1, 3, and 6 months. All children were followed up for at least 6 months.

Results: Fifty-three children received praziquantel (group A) and 50 placebo (group B). Complete resolution of lesions was seen in 60% and 72% of children at 3 and 6 months in group A versus 42% and 52% of children in group B. Nonresolution and calcification were higher in group B than in group A at 3 months (B: 28%, 14%; A: 12%, 8%) and 6 months (B: 16%, 22%; A: 6%, 9%), but the differences were not statistically significant. Seizure control and side effects were similar in the 2 groups.

Conclusions: A combination therapy for albendazole and praziquantel was statistically comparable to sole therapy with albendazole in eradicating lesions and preventing seizures.

Author Information

From the *Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India; and †Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Accepted for publication October 7, 2008.

Address for correspondence: Pratibha Singhi, MD, Pediatric Neurology and Neurodevelopment, Department of Pediatrics, Advanced Pediatric Center, PGIMER, Chandigarh, India. E-mail: pratibhasinghi@yahoo.com.

© 2009 Lippincott Williams & Wilkins, Inc.