Mepacrine therapy in niclosamide resistant taeniasis.

OBJECTIVE

To evaluate the efficacy of mepacrine (quinacrine) in patients with niclosamide resistant Taenia saginata infection.

METHODS

Eighty six cases with niclosamide resistant Taenia saginata (unresponsive to 2-8 courses of niclosamide) were treated with quinacrine (1 g) administered orally or via a nasogastric tube, and followed at 2, 4, 8 and 12 weeks for recurrence of passage of proglottids and presence of Taenia eggs in the stool examinations. Pre and post-therapy egg counts were obtained and egg viability was tested by staining with methylene blue.

RESULTS

Eighty-one (94.2%) patients responded promptly with passage of the worm within 4-72 hours. The egg counts showed a drastic fall in 79 cases and a fall in viability from a median of 100% to 0% was observed. Only one patient demonstrated a relapse at 4 weeks. Gastrointestinal side effects occurred in 9 cases but were controlled easily by symptomatic therapy.

CONCLUSION

We conclude that quinacrine is a safe, inexpensive, effective and generally well tolerated drug for the treatment of niclosamide resistant Taenia saginata infestations.