[Therapeutic alternatives in case of failure of first-line treatment of intestinal helminthiasis in adults].

Development of antiparasite medications over the last 15 years has greatly reduced the number of treatment failures for intestinal helminthiasis. Benzimidazole derivatives, ivermectine, praziquantel and triclabendazole are easy to use, well tolerated and generally curative. First-line treatment are currently so reliable that failure should lead first to investigation of possible "false failure" causes such as misdiagnosis, poor identification of the parasite, inadequate or incorrect treatment, and repeat contamination, before concluding that genuine parasite resistance is involved and that alternative therapy is needed. Nitazoxanide is an alternative treatment for fascioliasis and teniasis. Albendazole can be beneficial for taeniasis and strongyloidiasis. Metronidazole can be effective for fascioliasis. Artemisinine derivatives are useful for schistosomiasis. Combined therapies are necessary for refractory ankylostomiasis.