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Open Access 01-12-2018 | Research article

Medical treatment of cystic echinococcosis: systematic review and meta-analysis

Authors: Virginia Velasco-Tirado, Montserrat Alonso-Sardón, Amparo Lopez-Bernus, Ángela Romero-Alegría, Francisco Javier Burguillo, Antonio Muro, Adela Carpio-Pérez, Juan Luis Muñoz Bellido, Javier Pardo-Lledias, Miguel Cordero, Moncef Belhassen-García

Published in: BMC Infectious Diseases | Issue 1/2018

Abstract

Background

Cystic echinococcosis (CE) is a well-known neglected parasitic disease. However, evidence supporting the four current treatment modalities is inadequate, and treatment options remain controversial. The aim of this work is to analyse the available data to answer clinical questions regarding medical treatment of CE.

Methods

A thorough electronic search of the relevant literature without language restrictions was carried out using PubMed (Medline), Cochrane Central Register of Controlled Trials, BioMed, Database of Abstracts of Reviews of Effects, and Cochrane Plus databases up to February 1, 2017. All descriptive studies reporting an assessment of CE treatment and published in a peer-reviewed journal with available full-text were considered for a qualitative analysis. Randomized controlled trials were included in a quantitative meta-analysis. We used the standard methodological procedures established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Results

We included 33 studies related to the pharmacological treatment of CE in humans. Of these, 22 studies with levels of evidence 2 to 4 were qualitatively analysed, and 11 randomized controlled trials were quantitatively analysed by meta-analysis.

Conclusions

Treatment outcomes are better when surgery or PAIR (Puncture, Aspiration, Injection of protoscolicidal agent and Reaspiration) is combined with benzimidazole drugs given pre- and/or post-operation. Albendazole chemotherapy was found to be the primary pharmacological treatment to consider in the medical management of CE. Nevertheless, combined treatment with albendazole plus praziquantel resulted in higher scolicidal and anti-cyst activity and was more likely to result in cure or improvement relative to albendazole alone.

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Title: Medical treatment of cystic echinococcosis: systematic review and meta-analysis
Authors: Virginia Velasco-Tirado
Montserrat Alonso-Sardón
Amparo Lopez-Bernus
Ángela Romero-Alegría
Francisco Javier Burguillo
Antonio Muro
Adela Carpio-Pérez
Juan Luis Muñoz Bellido
Javier Pardo-Lledias
Miguel Cordero
Moncef Belhassen-García
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Infectious Diseases / Issue 1/2018
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-018-3201-y

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Medical treatment of cystic echinococcosis: systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

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Abstract

Background

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