Anthelmintic therapy: current approaches and challenges

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Three agents have recently proved to be effective, ivermectin, praziquantel, and albendazole have markedly improved the clinical management of helminthiases. These agents affect parasites which were previously difficult to control and simplify drug administration, making it easier to treat patients, especially in the field. These major developments in anthelmintic therapy have primarily assisted the treatment of tissue-based parasites; ivermectin for filariae, praziquantel for trematodes, and albendazole for intractable diseases such as cysticercosis. Recent literature focuses on the application of these chemotherapeutic agents to human parasitic diseases in different geographical areas. Resistance to ivermectin and benzimidazoles has developed in recent years in veterinary parasitic diseases and now threatens human parasitoses. Research efforts to find new drugs are concentrating on defining neurotransmitter blockers and modulators of tubulin and, more recently, chitin biology and parasite molting are areas being considered as suitable targets. The minimizing of side reactions to the destruction of parasites by chemotherapeutic agents also remains an area of concern, as does improvement in aspects of distribution and delivery of anthelmintics to logistically difficult areas.

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