Albendazole taken with food in a single dose, mebendazole for 3 days, or ivermectin taken on an empty stomach in a single dose are recommended for Treatment of ascariasis (see Drugs for Parasitic Infections). Although limited data suggest that these drugs are safe in children younger than 2 years of age, the risks and benefits of therapy should be considered before administration. In 1-year-old children, the World Health Organization recommends reducing the albendazole dose to half of that given to older children and adults. Albendazole is not labeled for use for Treatment of ascariasis. Nitazoxanide also is effective against A lumbricoides , although it also is not approved for this indication. Reexamination of stool specimens 2 weeks after therapy to determine whether the worms have been eliminated is helpful for assessing therapy but is not essential.

Conservative management of small bowel obstruction, including nasogastric suction and intravenous fluids, may result in resolution of major symptoms before administration of anthelminthic therapy. Piperazine, which may relieve intestinal obstruction caused by heavy worm burden, is not available in the United States. Surgical intervention occasionally is necessary to relieve intestinal or biliary tract obstruction or for volvulus or peritonitis secondary to perforation. Endoscopic retrograde cholangiopancreatography has been used successfully for extraction of worms from the biliary tree.