Filariasis

12 June 2012, by DEVELOUX M.

1 - LYMPHATIC FILARIASIS
Lymphatic filariasis is a helminthiasis transmitted by mosquitoes belonging to several genera.
These are tropical diseases whose chronic manifestations result from obstruction of the lymph
ducts by adult filariae [1].
1.1 - TREATMENT OPTIONS

The specific treatments are diethylcarbamazine and ivermectin.

Albendazole is proposed for the treatment of some cases of lymphatic filariasis in combination
with DEC or ivermectin, whose activity it enhances.
The discovery of Wolbachia genus bacteria in the pathophysiology of filariasis, Loa loa
excepted, has been fundamental. These symbiotic bacteria are always detected when the
nematodes are present. They are fundamental to the survival of the nematode and play a role in
the inflammatory phenomena observed with these infections. Wolbachia are sensitive to several
antibiotics, including certain tetracyclines such as doxycycline. Doxycycline therefore
constitutes a new, single-agent treatment option for lymphatic filariasis as it also has
macrofilaricide activity. It can also be combined with other standard filariasis treatments.
1.2 - TREATMENT STRATEGY

Antiparasite treatment is first and foremost indicated for asymptomatic patients with
microfilaraemia and patients with initial-stage clinically manifest disease. Whatever the
antifilarian agent used, treatment must be given at a distance from an acute infection.
The recommended treatment regimen with diethylcarbamazine is one 6 mg/kg dose every three
months. Courses of 10 to 21 days of diethylcarbamazine at a dose gradually incremented to reach
6 mg/kg a day are indicated for patients with tropical pulmonary eosinophilia or who also present
with loa loa filariasis or hypersensitivity to diethylcarbamazine.
Ivermectin may be used at a dose of 200 g/kg for six months [1]. The number of courses given
depends on the clinical and biological course of the disease.
Doxycycline cures the disease permanently. It is prescribed at a dose of 200 mg/day for 6 weeks
followed by a course of ivermectin, repeated 3 to 6 months later.

Treatment for an acute manifestation is symptomatic, combining rest, wet bandages, pain relief
and antibiotics, etc.
In patients with chronic-stage disease, antifilarian treatment may be of use if the lesions are
relatively recent since regression is still achievable. Some simple measures will help prevent the
onset of acute infectious flares which aggravate lymphoedema or elephantiasis: the interdigital
spaces must be kept scrupulously clean and cracked or broken skin must be treated with local
antiseptics, antibiotics and/or antifungal agents. Acute infection must always be treated with
antibiotics. Physical treatments (drainage) and binding can be used to help reduce swelling.
Surgery is mainly indicated for elephantiasis of the genitals.
On an individual level, prevention consists in avoiding mosquito bites. Mass
treatment campaigns in endemic zones are the best option for rapidly reducing the
incidence of lymphatic filariasis. The worldwide lymphatic filariasis reduction
program was launched in 2000 and covers 51 countries. Treatment consists of an
annual 200-400 g/kg dose of ivermectin combined with 400 mg albendazole. In loa
loa free areas, DEC can be given alone or at a dose of 6 mg/kg in combination with
400 mg albendazole. The courses of treatment must be given for at least 5
years. Annual courses of ivermectin (400 g/kg) or a combination of ivermectin (400
g/kg)-diethylcarbamazine (6 mg/kg) may be used [1].

http://www.therapeutique-dermatologique.org/spip.php?article1508

Doxycycline
Pronunciation
Generic Name: doxycycline (DOX i SYE kleen)
Brand Names: Acticlate, Adoxa, Alodox, Avidoxy, Doryx, Monodox, Morgidox, NicAzel Doxy
30, Ocudox Convenience Kit, Oracea, Oraxyl, Targadox, Vibramycin

What is doxycycline?
Doxycycline is a tetracycline antibiotic. It fights bacteria in the body.

Doxycycline is used to treat many different bacterial infections, such as acne, urinary tract
infections, intestinal infections, eye infections, gonorrhea, chlamydia, periodontitis (gum
disease), and others.
Doxycycline is also used to treat blemishes, bumps, and acne-like lesions caused by rosacea. It
will not treat facial redness caused by rosacea.
Some forms of doxycycline are used to prevent malaria, to treat anthrax, or to treat infections
caused by mites, ticks, or lice.
https://www.drugs.com/doxycycline.html

ANTIBIOTICS DOXYCYCLINE & BACTRIM: Morgellons, Strongyloides, & Filariasis

For Parasite Warriors ~~

Following is an excerpt from the Albendazole & Ivermectin Protocol ~
Strongyloides, Filariasis, & Morgellons: http://curezone.com/forums/fm.asp?i=1586882#i
Antibiotics: Parasites, larva, & eggs that migrate or scatter carry
enteric bacteria & pathogens from the GI tract. They may (but not
always) spread bacterial infections throughout the body (e.g., respiratory
tract, mucous membranes, genitourinary tract, organs, skin, soft tissue,
eyes, ears, etc).
At the beginning of parasite drug treatment, I took Bactrim DS (DoubleStrength), 800/160mg, twice daily, for 4 weeks, for soft tissue, sinus,
urinary tract, & lung bacterial infections caused by dissemminated
parasites & die-off.
If allergic to Bactrim, see optional antibiotics below.

If you don't have bacterial infections (such as those listed above), skip
taking the Bactrim. However, suggest you keep a supply of this antibiotic
on hand for infections that may develop from die-off after starting drug
treatment.
Morgellons: Since Bactrim heals skin & soft tissue infections, recommend
taking it during first 4 wks of above drug treatment to enhance healing of
parasitic die-off in Morgellons sores & lesions.
When finished taking the Bactrim, I then took Doxycycline, 100mg, twice
daily, for 6 weeks.
Doxycycline enhances the synergistic & antiparasitic effects of
Ivermectin & results in higher cure rates. It's a key element in
treatment of Strongyloides, Filariasis, & Morgellons. If treating those
infections, do not skip taking this drug.
If Bactrim or other antibiotics are not taken for bacterial infections,
then start taking Doxycline at the beginning of parasite drug treatment.
Do not take Bactrim (or other antibiotics) & Doxycycline together or
during the same time period. Finish the dosage cycle of one
antibiotic before starting the next antibiotic.
Bactrim DS/Sulfamethoxazole-Trimethoprim/SMZ-TMP): (For
Morgellons & Bacterial Infections) First 4 wks of parasite drug treatment: 1
tablet*, twice daily, evenly spaced 12 hours apart, with 8oz water. If unsure of
sulfa drug allergy, take gradual dose increases: 1/2 tablet first day, 1
tablet second day, 1-1/2 tablet third day, & 2 tablets daily thereafter. This slow
"ramp-up" dosage method generally prevents allergic reaction.
*Two tablet sizes are available: Bactrim 400/80mg (Regular Strength) & Bactrim
DS 800/160mg (Double Strength). There are 61 brands of Bactrim
(Sulfamethoxazole-Trimethoprim, SMZ-TMP): http://www.druginfosys.com/AlterBrandResult.aspx?
code=9406&packing=13859

Doxycycline Hyclate/Vibra-Tabs/Vibramycin: (For Strongyloides,

Filariasis, & Morgellons) Next 6 wks of parasite drug treatment: 1 tablet, 100mg,
twice daily, evenly spaced 12 hrs apart. Take on empty stomach, 1 hour before or 2
hours after a meal, with 8oz water. Take 2-3 hrs before or after products
containing aluminum, calcium, iron, magnesium, zinc, or bismuth subsalicylate.
Examples: Antacids, Didanosine, Quinapril, vitamins w/minerals, dairy products
(e.g., milk, yogurt), & calcium-enriched juice. These bind with Doxycycline &
prevent full absorption. Do not lie down for 15 mins to prevent acid reflux. Avoid
prolonged exposure to direct sunlight. For nausea, eat a light nondairy
snack, saltine or soda crackers, or drink lemon-lime carbonated beverages (e.g., 7up, Sprite, etc). (http://www.webmd.com/drugs/mono7073DOXYCYCLINE+
+ORAL.aspxdrugid=8648&drugname=Doxycycline+Hyclate+Oral)

Optional antibiotics: Amoxicillin, Augmentin, Azithromycin, Cephalexin

(Keflex), Ciprofloxacin (Cipro), Clindamycin, Minocycline (Dynacin,
Solodyn), Tetracycline, & Zithromax.
http://www.curezone.org/forums/am.asp?i=1762066

A single dose of doxycycline in combination with diethylcarbamazine for treatment

of bancroftian filariasis.
Sanprasert V1, Sujariyakul A, Nuchprayoon S.
Author information
Abstract

Standard treatment of lymphatic filariasis with diethylcarbamazine (DEC) is associated with

systemic adverse reactions, thought to be due to the release of microfilariae material and
Wolbachia endosymbiotic bacteria into the blood. Combination treatments with doxycycline for
3-8 weeks are more effective than standard treatment. However, long-term use of antibiotics may
contribute to drug resistance and are not practical for use in remote areas. We assessed whether a
single dose of doxycycline combined with the standard DEC regimen would reduce the
incidence and severity of adverse reactions and increase the efficacy of standard treatment.
Forty-four subjects from Tak Province were recruited into the randomized double-blind clinical

trial study: 25 received DEC (300 mg) combined with a placebo, and 19 received DEC (300 mg)
combined with doxycycline (200 mg). The incidences of adverse reactions to standard treatment
were lower in the doxycycline group (45.5%) than in the placebo group (58.8%). Severe
reactions occurred only in the placebo group (3 of 25 subjects). The severity of adverse reactions
was significantly lower in the doxycycline group (mean score 0.45) than in the placebo group
(mean score 1.17). The levels of IL-6 and Wolbachia DNA in the plasma were significantly
lower in the doxycycline group. The filarial antigen levels were significantly lower in the
doxycycline group at months 6 after treatment.
http://www.ncbi.nlm.nih.gov/pubmed/21073054

How do you Treat Filariasis?

Diethylcarbamazine (DEC) is the recommended medicine for treating filariasis. It
kills microfilaria and does not have any effect on the adult worms. Thus, it only
helps to control transmission of infection from one person to other. It may cause a
reaction in some individuals. Ivermectin or albendazole may be useful in some
patients.
Good hygiene of the affected part prevents the worsening of the lymphedema and
secondary bacterial skin infections.
The affected limb should be kept elevated and regular exercises should be done to
improve the lymph flow.
http://www.medindia.net/patients/patientinfo/diagnosis-and-treatment-offilariasis.htm

Doxycycline to treat Elephantiasis

Elephantiasis can be treated with a low-priced antibiotic, according to scientists.It causes severe
swelling in the limbs or scrotum.

Doxycycline was used to treat LF in 51 patients in Ghana. The antibiotic not only
killed the worm but also provided relief from symptoms. Lymphatic Filariasis (LF)
http://www.medindia.net/news/view_news_main.asp?x=14571

http://www.medplusmart.com/drugsCategory/MEDICINES/Anthelmintics/10074/1009
0
http://www.medplusmart.com/drugsCategory/MEDICINES/Anthelmintics/10074/1009
0

http://www.medplusmart.com/product/LIZA-DEC-TABLET/LIZA0003
LIZA DEC TABLET
Mfg:
CASSEL PHARMA
(Other Products from CASSEL PHARMA)

Comp:
Diethylcarbamazine 150 MG+Levocetirizine 2.5 MG
Form:
TABLET
Pack Size:
10 (Units)
MRP (per pack) :
Rs. 31.90

DECET 150MG TABLET

Mfg:
RND LABORATORIES
(Other Products from RND LABORATORIES)

Comp:
Diethylcarbamazine 150 MG
Form:
TABLET
Pack Size:
10 (Units)
MRP (per pack) :
Rs. 37.90

DICARB INGA TABLET

Mfg:
INGA LABORATORIES
(Other Products from INGA LABORATORIES)

Comp:
Chlorpheniramine maleate 2 MG+Diethylcarbamazine 100 MG
Form:
TABLET
Pack Size:
10 (Units)
MRP (per pack) :
Rs. 13.00