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Parenteral administration of ivermectin in a patient with disseminated strongyloidiasis.
Am J Trop Med Hyg. 2005 Nov; 73(5):911-4.AJ

Abstract

We report the case of a 23-year-old Caribbean man with disseminated strongyloidiasis (co-infected with human T cell lymphotropic virus I/II)), severe hypoalbuminemia, and a paralytic ileus. Subcutaneous ivermectin (200 microg/kg) was administered daily for 14 days because of the inability to effectively administer oral albendazole and oral ivermectin. Three hours after the third daily dose of oral ivermectin, the serum ivermectin concentration was only 0.8 ng/mL, but it increased several fold to 5.8 ng/mL 16 hours after the first dose of subcutaneous ivermectin. During the course of subcutaneous treatment, ivermectin clearance was higher than expected (46.0 L/hour, normal = 31.8 L/hour). This is likely the result of severe hypoalbuminemia since ivermectin is highly protein bound. The ability to achieve adequate levels of ivermectin after oral administration in patients with disseminated strongyloidiasis may be impaired, highlighting the need for alternative routes of administration of ivermectin in these patients.

Authors+Show Affiliations

Division of Infectious Diseases, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16282302

Citation

Turner, Stephen A., et al. "Parenteral Administration of Ivermectin in a Patient With Disseminated Strongyloidiasis." The American Journal of Tropical Medicine and Hygiene, vol. 73, no. 5, 2005, pp. 911-4.
Turner SA, Maclean JD, Fleckenstein L, et al. Parenteral administration of ivermectin in a patient with disseminated strongyloidiasis. Am J Trop Med Hyg. 2005;73(5):911-4.
Turner, S. A., Maclean, J. D., Fleckenstein, L., & Greenaway, C. (2005). Parenteral administration of ivermectin in a patient with disseminated strongyloidiasis. The American Journal of Tropical Medicine and Hygiene, 73(5), 911-4.
Turner SA, et al. Parenteral Administration of Ivermectin in a Patient With Disseminated Strongyloidiasis. Am J Trop Med Hyg. 2005;73(5):911-4. PubMed PMID: 16282302.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parenteral administration of ivermectin in a patient with disseminated strongyloidiasis. AU - Turner,Stephen A, AU - Maclean,J Dick, AU - Fleckenstein,Lawrence, AU - Greenaway,Christina, PY - 2005/11/12/pubmed PY - 2006/1/13/medline PY - 2005/11/12/entrez SP - 911 EP - 4 JF - The American journal of tropical medicine and hygiene JO - Am J Trop Med Hyg VL - 73 IS - 5 N2 - We report the case of a 23-year-old Caribbean man with disseminated strongyloidiasis (co-infected with human T cell lymphotropic virus I/II)), severe hypoalbuminemia, and a paralytic ileus. Subcutaneous ivermectin (200 microg/kg) was administered daily for 14 days because of the inability to effectively administer oral albendazole and oral ivermectin. Three hours after the third daily dose of oral ivermectin, the serum ivermectin concentration was only 0.8 ng/mL, but it increased several fold to 5.8 ng/mL 16 hours after the first dose of subcutaneous ivermectin. During the course of subcutaneous treatment, ivermectin clearance was higher than expected (46.0 L/hour, normal = 31.8 L/hour). This is likely the result of severe hypoalbuminemia since ivermectin is highly protein bound. The ability to achieve adequate levels of ivermectin after oral administration in patients with disseminated strongyloidiasis may be impaired, highlighting the need for alternative routes of administration of ivermectin in these patients. SN - 0002-9637 UR - https://www.unboundmedicine.com/medline/citation/16282302/Parenteral_administration_of_ivermectin_in_a_patient_with_disseminated_strongyloidiasis_ L2 - https://www.diseaseinfosearch.org/result/6902 DB - PRIME DP - Unbound Medicine ER -