Drug of choice for strongyloides stercoralis?
**Core Concept**
Strongyloidiasis, caused by the parasitic worm Strongyloides stercoralis, is a helminthic infection that can lead to autoinfection and potentially life-threatening complications. The treatment of choice must effectively kill the worm and prevent its autoinfective cycle.
**Why the Correct Answer is Right**
Ivermectin is the preferred treatment for strongyloidiasis due to its high efficacy and ability to target the worm's nervous system. It acts by activating glutamate-gated chloride channels, leading to an influx of chloride ions and hyperpolarization of the worm's muscles, ultimately causing paralysis and death. Ivermectin's effectiveness in treating strongyloidiasis is well-documented, particularly in cases of immunocompromised individuals who are at risk of developing hyperinfection syndrome.
**Why Each Wrong Option is Incorrect**
**Option A:** Mebendazole, while effective against other types of helminthic infections, has limited efficacy against Strongyloides stercoralis and is not the preferred treatment.
**Option B:** Albendazole, another broad-spectrum anthelmintic, is not the first-line treatment for strongyloidiasis and may not be as effective as ivermectin.
**Option D:** Levamisole, an immunomodulatory agent with some anthelmintic properties, is not the preferred treatment for strongyloidiasis and may not provide adequate coverage against the worm.
**Clinical Pearl / High-Yield Fact**
In cases of strongyloidiasis, particularly in immunocompromised patients, it is essential to administer ivermectin for an extended period (14-21 days) to prevent autoinfection and ensure complete clearance of the worm.
✓ Correct Answer: C. Ivermectin