Ivermectin for the treatment of periodic malayan filariasis: a study of efficacy and side effects following a single oral dose and retreatment at six months

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Abstract
Ivermectin, a new antifilarial drug and currently the drug of choice for the treatment of onchocerciasis, has been shown to be effective in bancroftian filariasis. We report here, for the first time, the efficacy and safety of the drug in the treatment of filariasis caused by periodic Brugia malayi. Sixty male, asymptomatic microfilaraemics of Alleppey district, Kerala, South India, received single oral doses of ivermectin in a double blind study. Four dosages were used: 20, 50, 100 and 200 μg kg−1 body weight. Clearance of microfilariae, which was not complete, began as early as 12 hours post-treatment and was maximal at the end of one month. Microfilaria levels began to rise thereafter and reached 20–50% of pretreatment levels at six months. The two higher doses (100 and 200 μg kg−1) were more effective in suppressing microfilaraemia at six months (P0·05) or pretreatment levels of microfilariae. Although a single dose of ivermectin did not produce complete clearance of microfilaraemia, the ability of the drug to partially clear microfilariae while producing minimal reactions suggests that it may prove useful in the treatment of filariasis caused by periodic Brugia malayi. Further studies need to be carried out to determine the optimal dose of ivermectin to achieve total clearance and the spacing of doses, if multiple doses are to be used.

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