Letter to the Editor

Thank you very much for your letter and the complimentary issue of number 7 Volume 16 of the Infectious Disease Alert of January 1, 1997, where you included an abstract of our paper on the single-dose ivermectin treatment for intestinal helminth infections (pg. 56).

Unfortunately, some errors have occured in the abstract. So, all individuals with first or third stage larvae of S. stercoralis were included in the study, not only the ones with the L3. Furthermore, and more importantly, some figures have been mixed up in the table of cure rates, which leads to exactly the opposite conclusions than the ones we reached in our original paper. The cure rates for S. stercoralis in our study were 82.9% for ivermectin and 45% for albendazole, and in the case of hookworms, 0% for ivermectin and 88.3% for albendazole, while you quoted these figures exactly the other way round. This, of course, leads to the wrong conclusion that albendazole is not effective against hookworms, while in fact this is true for ivermectin. Worse still, the high cure rate of single-dose ivermectin for S. stercoralis, which last November led to the registration of this drug in the USA for treatment of human infections, is actually reduced to a very mediocre efficacy.

The following table shows the correct cure rates.

Table

Cure rates

ivermectin albendazole

Parasite species cure rate cure rate

S. stercoralis 82.9% 45.0% A. lumbricoides 100.0% 99.0% T. trichiura 11.3% 42.6% Hookworms 0.0% 88.3%

Thank you very much in advance, I remain

Yours sincerely,

Dr. Hanspeter Marti

Response from Dr. Carol Kemper:

I apologize for the errors in transposition of the corresponding therapeutic efficacies of these two agents. While ivermectin is effective in the treatment of strongyloides, it is in fact not very effective against whipworm, nor is it effective against hookworms. In contrast, albendazole was 88.3% effective in the treatment of hookworms. These figures were, unfortunately, transposed in the original table. Both drugs were similarly uniformly effective against ascaris.

Sincerely,

Carol A. Kemper, MD