Clinical Care of Schistosomiasis - CDC

Treatment in Pregnancy

Praziquantel is a pregnancy category B drug. There are no adequate and well-controlled studies in pregnant women. However, the available evidence suggests no difference in adverse birth outcomes in the children of women who were accidentally treated with praziquantel during mass drug administration (MDA) campaigns compared with those who were not. In MDA campaigns for which the World Health Organization (WHO) has determined that the benefit of treatment outweighs the risk, WHO encourages the use of praziquantel in any stage of pregnancy. For individual patients in clinical settings, healthcare providers should consider the risk of treatment in infected pregnant women with the risk of disease progression in the absence of treatment.

Pregnancy Category B: Either animal-reproduction studies have not demonstrated a fetal risk plus there are no controlled studies in pregnant women, or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the first trimester (and there is no evidence of a risk in later trimesters).

Treatment During Lactation

Praziquantel is excreted in low concentrations in breast milk. According to WHO guidelines for MDA campaigns, the use of praziquantel during lactation is encouraged. For individual patients in clinical settings, healthcare providers should consider the risk of treatment in infected breastfeeding women with the risk of disease progression in the absence of treatment.

Treatment in Pediatric Patients

A recent study states that "Arpraziquantel, a first-line orodispersible tablet, showed high efficacy and favourable safety in preschool-aged children with schistosomiasis."¹

_{¹N'Goran EK, Odiere MR, Assandé Aka R, Ouattara M, Aka NAD, Ogutu B, Rawago F, Bagchus WM, Bödding M, Kourany-Lefoll E, Tappert A, Yin X, Bezuidenhout D, Badenhorst H, Huber E, Dälken B, Haj-Ali Saflo O. Efficacy, safety, and palatability of arpraziquantel (L-praziquantel) orodispersible tablets in children aged 3 months to 6 years infected with Schistosoma in Côte d'Ivoire and Kenya: an open-label, partly randomised, phase 3 trial. Lancet Infect Dis. 2023 Jul;23(7):867-876. doi: 10.1016/S1473-3099(23)00048-8. Epub 2023 Mar 6. PMID: 36893784.}

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