***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Although trichuriasis affects millions of children worldwide , recommended drugs lack efficacy and new treatment options are urgently needed . Ivermectin has promising potential to complement the anthelminthic armamentarium . Methods A r and omized placebo-controlled trial was conducted in rural Côte d'Ivoire to provide evidence on the efficacy and safety of ascending oral ivermectin dosages in preschool-aged children ( PSAC ) and school-aged children ( SAC ) infected with Trichuris trichiura . The primary outcome was the cure rate ( CR ) for T. trichiura infection , and the secondary outcomes were safety , egg-reduction rates ( ERRs ) against T. trichiura infection , and CRs and ERRs against other soil-transmitted helminth species . Results A total of 126 PSAC and 166 SAC were included in an available case analysis . In PSAC , efficacy against T. trichiura did not differ between 200 µg/kg ivermectin and placebo treatment arm , as expressed in CRs ( 20.9 % [ 95 % confidence interval { CI } , 11.9%-52.8 % ] vs 19.5 % [ 10.4%-49.9 % ] ) and geometric mean ERRs ( 78.6 % [ 60.1%-89.5 % ] vs 68.2 % [ 40.5%-84.8 % ] ) . In SAC , the highest administered ivermectin dose of 600 µg/kg had a low CRs ( 12.2 % [ 95 % CI , 4.8%-32.3 % ] ) and moderate ERRs ( 66.3 % [ 43.8%-80.2 % ] ) . Only mild adverse events and no organ toxicity , based on serum biomarkers , was observed . Conclusion Ivermectin can be administered safely to PSAC with trichuriasis . Given the low efficacy of ivermectin monotherapy against T. trichiura infection , further research should investigate the optimal drug combinations and dosages with ivermectin against soil-transmitted helminthiasis . Clinical Trials Registration IS RCT N15871729 ( www.is rct n.com ) The pharmacokinetic interactions and tolerability of albendazole , praziquantel and ivermectin combinations were assessed in 23 healthy Thai volunteers ( 12 males and 11 females ) . The study was an open , r and omised , three-way crossover design in which each subject attended the study on three separate occasions ( Phases I , II and III ) , of 4 d or 8 d each , with at least 1 or 2 weeks ( but not longer than 2 months ) between each phase . All subjects received the three study drug regimens as follows : regimen I , oral praziquantel ( 40 mg/kg body weight ) ; regimen II , oral ivermectin ( 200 microg/kg body weight ) given concurrently with an oral dose of albendazole ( 400 mg ) ; and regimen III , oral ivermectin given concurrently with albendazole and praziquantel . All treatment regimens showed acceptable tolerability profiles . The incidence of overall drug-related adverse events was significantly higher following regimens I ( 12/23 ) and III ( 7/23 ) compared with that following regimen II ( 0/23 ) . Six statistically significant changes in the pharmacokinetic parameters of albendazole sulphoxide ( Cmax , AUC0-infinity , Vz/F , CL/F ) , praziquantel ( Vz/F ) and ivermectin ( AUC0-infinity ) were observed when the three drugs were given concurrently . However , based on US Food and Drug Administration criteria , these changes were not considered of clinical relevance Azithromycin is a critical component of an integrated disease elimination program against trachoma . This study was conducted to evaluate whether azithromycin has a pharmacokinetic interaction with the combination of ivermectin and albendazole .  Eighteen healthy volunteers were administered single doses of azithromycin , ivermectin/albendazole , and the combination of the three agents in r and om , crossover fashion . To assess the presence of interactions , test ( combination ) and reference ( single dose ) data were compared using an estimation approach . Compared with reference phases , the geometric mean values for the combination arm 's  azithromycin AUC(0-t ) and C(max ) were increased approximately 13 % and 20 % , respectively ,  albendazole AUC(0-t ) decreased by approximately 3 % and C(max ) increased approximately 3 % , and  ivermectin AUC(0-t ) and C(max ) were increased 31 % and 27 % , respectively .  Albendazole sulfoxide AUC(0-t ) and C(max ) were decreased approximately 16 % and 14 % , respectively . All treatments were well tolerated . The interactions for  azithromycin and albendazole  were minimal although the increase in ivermectin exposure requires further study Ivermectin is a potent microfilaricide that also blocks microfilarial release while albendazole is toxic to all intrauterine stages . We investigated whether their combination would permanently sterilize the adult worms . In the first open phase , all 69 patients received 150 micrograms/kg of ivermectin .  In the second double-blind phase one week later , 35 patients were r and omized to receive 800 mg of albendazole with a fatty breakfast for three consecutive days while 34 patients received matching placebo tablets . Detailed clinical and laboratory examinations were done before treatment and were repeated at intervals over one year . Nodules were excised at three and six months . There was a rapid reduction in skin microfilariae , maximal at four weeks ( 99.9 % ) . Counts increased subsequently and were between 11 and 18 % of initial values at one year . Nodule histology showed no macrofilaricidal activity of the combination . A high proportion of the stretched intrauterine microfilariae were degenerate in both groups . Anterior chamber microfilarial counts were unchanged until day 18 and then fell successively . Low levels persisted in several patients at one year . Dead corneal microfilariae and corneal punctate opacities increased initially , fell with time and then disappeared in most patients . Systemic and ocular reactions were mild to moderate and biochemical abnormalities were minor . A pronounced posttreatment eosinophilia subsided by day 30 . There was no significant difference between the two groups in clinical and laboratory tolerance or in alterations in skin and ocular parasites and no important differences in the effect on the adult worms . The combination of ivermectin with albendazole given one week apart is well tolerated but produces no additional effect against Onchocerca volvulus when compared to ivermectin given alone Abstract The safety and efficacy of a single dose of ivermectin alone ( 150–200 μg/kg bodyweight ) , albendazole alone ( 400 mg ) or the combination of these two drugs was assessed , in Ug and a , in three groups of individuals infected with Mansonella perstans ( with 15 , 13 and 15 subjects in each group , respectively ) .  No side-effects were observed or reported during the first 7 days post-treatment and every subject remained microfilaraemic during the 12 months of follow-up . In the subjects given ivermectin alone or albendazole alone , the microfilarial intensities consistently remained close to their pre-treatment levels . In the subjects given both drugs , however , the microfilarial intensities decreased slightly after treatment and at 1 and 3 months post-treatment ( but not at 6 , 9 or 12 months ) they were significantly lower than in the two other groups combined . The three single-dose drug regimens investigated were thus well tolerated but had disappointingly low efficacies in the treatment of M. perstans microfilaraemias Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND Single-dose albendazole and mebendazole show limited efficacy in the treatment of trichuriasis . The combination of albendazole with ivermectin improves efficacy , but a mebendazole-ivermectin combination has not been previously investigated . METHODS We performed a r and omized controlled trial in 2 schools in Zanzibar , Tanzania , to assess the efficacy and safety of albendazole ( 400 mg ) plus placebo , albendazole plus ivermectin ( 200 μg/kg ) , mebendazole ( 500 mg ) plus placebo , and mebendazole plus ivermectin in children with a parasitologically confirmed Trichuris trichiura infection .  Cure rate ( CR ) and egg reduction rate were assessed by intent-to-treat analysis . Adverse events were monitored within 48 h after treatment . RESULTS Complete data records were available for 548 children . The highest CR against T. trichiura was achieved with a mebendazole-ivermectin combination ( 55 % ) . Low CRs were observed with albendazole-ivermectin ( 38 % ) , mebendazole ( 19 % ) , and albendazole ( 10 % ) . Compared with placebo , the use of ivermectin statistically significantly increased the CRs from 14 % to 47 % ( odds ratio , 0.19 ; 95 % confidence interval [ CI ] , 0.12 - 0.28 ) . The highest egg reduction rate ( 97 % ; 95 % CI , 95%-98 % ) was observed using the mebendazole-ivermectin combination , followed by albendazole-ivermectin ( 91 % ; 95 % CI , 87%-94 % ) , mebendazole ( 67 % ; 95 % CI , 52%-77 % ) , and albendazole ( 40 % ; 95 % CI , 22%-56 % ) . The adverse events , reported by 136 children , were generally mild , with no significant difference between the treatment arms . CONCLUSIONS Addition of ivermectin  improves the therapeutic outcomes of both albendazole and mebendazole against T. trichiura and may be considered for use in soil-transmitted helminth control programs and individual patient management . TRIAL REGISTRATION is rct n.org Identifier : IS RCT N08336605 OBJECTIVE To evaluate the efficacy of and resistance to mebendazole ( 500 mg ) and levamisole ( 40 or 80 mg ) , alone or in combination , for the treatment of Ascaris lumbricoides , Trichuris trichiura and hookworm infections on Pemba Isl and - an area exposed to periodic school-based mebendazole treatment since 1994 . METHODS A r and omized , placebo-controlled trial was carried out in 914 children enrolled from the first and fifth grade s of primary schools . Stool sample s collected at baseline and 21 days after treatment were examined by the Kato-Katz technique to assess the prevalence and intensity of helminth infection . FINDINGS Efficacies of mebendazole and levamisole as single treatments against intestinal nematode infections were comparable with those in previous trials , but mebendazole treatment of hookworm infections gave significantly lower cure ( 7.6 % ) and egg reduction ( 52.1 % ) rates than reported in a study undertaken before the beginning of periodic chemotherapy ( cure rate , 22.4 % ; egg reduction rate , 82.4 % ) . Combined treatment with mebendazole and levamisole had a significantly higher efficacy against hookworm infections ( cure rate , 26.1 % ; egg reduction rate , 88.7 % ) than either drug given alone . No difference in  mebendazole efficacy was found in children who had been treated repeatedly compared with those who had not been treated previously . CONCLUSION The overall efficacy of mebendazole against hookworm infections after periodic chemotherapy is reduced . The efficacy of benzimidazoles in chemotherapy-based control programmes should be monitored closely . Combined treatment with mebendazole and levamisole may be useful as a tool to delay the development of benzimidazole resistance This r and omized , placebo-controlled trial investigated the efficacy and nutritional benefit of combining chemotherapeutic treatment for intestinal helminths ( albendazole ) and lymphatic filariasis ( ivermectin ) . Children were infected with Ascaris ( 29.2 % ) , Trichuris ( 42.2 % ) , and hookworm ( 6.9 % ) , with 54.7 % of children having one or more of these parasites . Wuchereria bancrofti microfilaria were found in 13.3 % of the children . Children were r and omly assigned to treatment with placebo , albendazole , ivermectin , or combined therapy . Combination treatment reduced the prevalence of Trichuris infections significantly more than either drug alone . Combination therapy also significantly reduced the prevalence and density of W. bancrofti microfilaremia compared with placebo or ivermectin alone . Only combination therapy result ed in significantly greater gains in height ( hookworm-infected children ) or weight ( Trichuris-infected children ) compared with the placebo group . Combined  albendazole and ivermect 
    Output:
    
The co-administration revealed no or only a marginal benefit on cure and egg reduction rates  over albendazole alone for A. lumbricoides and hookworm infections .
Adverse events ( AEs ) occurring after ivermectin-albendazole co-administration were mostly mild and transient .
Conclusions Our findings suggest a good tolerability and higher efficacy of ivermectin-albendazole against T. trichiura compared to the current st and ard single-dose albendazole treatment , which supports the use of this co-administration in PC programs .