Controlled comparative trial of thiabendazole and metronidazole in the treatment of dracontiasis

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Abstract
In a placebo-controlled field trial involving 111 cases of dracontiasis, thiabendazole (at 50 mg kg−1daily for two days or 100 mg kg−1 daily for two days) was compared with metronidazole (at 30–40 mg kg−1 t.d.s. for three days) for effectiveness against the guinea-worm, Dracunculus medinensis. All three regimens gave similar results and were significantly more effective than the placebo in bringing relief from symptoms of the disease and in the healing of guinea-worm ulcers. Elimination of adult worms was more rapid, but not significantly so, in patients treated with anthelmintic than in the control group. Clinical and parasitological relapses were less frequent in the treated patients. Metronidazole was generally well tolerated but transient dose-related side-effects, mostly gastrointestinal, occurred in about 50% of patients treated with thiabendazole. Nevertheless, it is concluded that both anthelmintics are clinically significantly effective in the treatment of dracontiasis.

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