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1.
Vet Parasitol ; 327: 110114, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38286060

RESUMEN

Aelurostrongylus abstrusus is the most important respiratory nematode of domestic cats. Effective control options are crucial to protect health and welfare of cats and to reduce the spread of aelurostrongylosis in both enzootic and free regions. The present study evaluated the efficacy of a spot-on formulation containing 280 mg/ml fluralaner and 14 mg/ml moxidectin (Bravecto® Plus, MSD) in the prevention of aelurostrongylosis in cats under field conditions. One hundred and fifty-two cats from Italy, Hungary and Bulgaria, were randomly divided in two groups, one treated with Bravecto® Plus on Study Days (SDs) 0 and 84 (74 cats, IVP Group) and one left untreated (78 cats, control group). Faecal samples were collected from all animals on SDs 42 ± 4, 84, 126 ± 4 and 168 ± 4 and subjected to the Baermann's technique and species-specific PCR for A. abstrusus. Each cat was subjected to a clinical examination on SDs 0, 84 and 168 ± 4 to check health condition and possible adverse events. The results of the faecal analysis were statistically analyzed for treatment group differences in the percentage of cats negative to the Baermann's test and PCR and percentage of reduction of fecal larvae counts as the primary and secondary efficacy criteria, respectively. The percentage of negative cats was higher in the IVP group compared to the control group and the percentage of reduction of fecal larvae counts in the IVP group compared to the control group was 100%. These results show that two administrations of Bravecto Plus® spot-on 12 weeks apart were safe and effective in the prevention of aelurostrongylosis for a period of almost 6 months.


Asunto(s)
Enfermedades de los Gatos , Isoxazoles , Metastrongyloidea , Infecciones por Nematodos , Animales , Gatos , Administración Tópica , Macrólidos/uso terapéutico , Infecciones por Nematodos/veterinaria , Larva , Enfermedades de los Gatos/tratamiento farmacológico , Enfermedades de los Gatos/prevención & control
2.
Parasit Vectors ; 16(1): 252, 2023 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-37501160

RESUMEN

BACKGROUND: The isoxazoline fluralaner is effective for prevention of Babesia canis transmission from infected Dermacentor reticulatus ticks to dogs for 84 days in a controlled environment. This study was designed to evaluate the effectiveness of fluralaner chewable tablets for sustained prevention of B. canis infection of dogs in endemic areas under natural conditions. METHODS: In Europe, privately owned, clinically healthy pet dogs were enrolled and randomized either to receive fluralaner at 25-56 mg/kg (Bravecto® chewable tablets) on days 0 and 84, or to remain untreated during the D. reticulatus season. Blood samples were collected to evaluate B. canis exposure: on days 0 and 21 (exposure before day 0), during the study and at the end of the tick season (dogs suspected of having become infected after day 0). Efficacy was determined by the percentage reduction in B. canis transmission risk based on the difference in B. canis-positive tests in fluralaner-treated dogs compared with untreated dogs. In addition, ticks collected at monthly intervals throughout the study were identified to species level and females tested for B. canis DNA. RESULTS: A total of 152 dogs were enrolled in the study, although nine dogs were excluded because they tested positive for B. canis DNA or antibodies within 21 days after enrollment. During the study period, no fluralaner-treated dog became positive for B. canis, resulting in calculated efficacy of 100%. However, babesiosis infection was diagnosed in five untreated control dogs (Fisher's exact test, left-sided, P = 0.0312). Tick analyses revealed that one sample collected in Hungary was infected with B. canis. CONCLUSION: Oral administration of Bravecto chewable tablets at the recommended dosage to dogs completely prevented B. canis transmission under field conditions in an endemic area for 12 weeks.


Asunto(s)
Babesia , Babesiosis , Dermacentor , Enfermedades de los Perros , Infestaciones por Garrapatas , Animales , Perros , Femenino , Babesia/genética , Babesiosis/epidemiología , Dermacentor/genética , ADN , Enfermedades de los Perros/epidemiología , Comprimidos , Infestaciones por Garrapatas/prevención & control , Infestaciones por Garrapatas/veterinaria
3.
Parasite ; 28: 26, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33812458

RESUMEN

Esafoxolaner, a purified enantiomer of afoxolaner with insecticidal and acaricidal properties, is combined with eprinomectin and praziquantel, nematodicidal and cestodicidal compounds, in NexGard® Combo, a novel topical endectoparasiticide formulation for cats. The efficacy of this formulation was assessed against Otodectes cynotis in two laboratory studies conducted in South Africa and in the USA with local isolates, and in one field trial conducted in Europe. In each study, cats were randomly allocated to a placebo-treated control group and a novel formulation-treated group. In the laboratory studies, cats were treated at the minimum recommended dose; in the field trial, cats were treated at label dose. All included cats were diagnosed positive for O. cynotis prior to treatment by otoscopy. The main variable of efficacy was a comparison of the number of live O. cynotis collected in both ear canals of all cats in the treated and control groups, one month after treatment. Efficacy of the novel topical formulation exceeded 97% in the three studies. These studies demonstrated the high effectiveness of NexGard® Combo in cats for the treatment of O. cynotis infestations. No health abnormalities were attributed to the treatment in any of the studies.


TITLE: Efficacité d'une nouvelle association topique d'esafoxolaner, d'éprinomectine et de praziquantel contre les infestations par l'acarien agent de la gale des oreilles Otodectes cynotis chez les chats. ABSTRACT: L'esafoxolaner, un énantiomère purifié d'afoxolaner aux propriétés insecticides et acaricides, est associé à l'éprinomectine et au praziquantel, composés nématodicides et cestodicides, dans NexGard® Combo, une nouvelle formulation endectoparasiticide topique pour chats. L'efficacité de cette formulation a été évaluée contre Otodectes cynotis dans deux études de laboratoire menées en Afrique du Sud et aux États-Unis avec des isolats locaux, et dans un essai sur le terrain mené en Europe. Dans chaque étude, les chats ont été répartis au hasard entre un groupe témoin traité par placebo et un groupe traité par la nouvelle formulation. Dans les études de laboratoire, les chats ont été traités à la dose minimale recommandée, et dans l'essai sur le terrain, les chats ont été traités à la dose indiquée sur l'étiquette. Tous les chats inclus ont été diagnostiqués positifs pour O. cynotis avant le traitement par otoscopie. La principale variable d'efficacité était une comparaison du nombre d'O. cynotis vivants, collectés dans les deux conduits auditifs de tous les chats, dans le groupe traité et dans le groupe témoin, un mois après le traitement. L'efficacité de la nouvelle formulation topique a dépassé 97 % dans les trois études. Ces études ont démontré la grande efficacité de NexGard® Combo chez les chats pour le traitement des infestations par O. cynotis. Aucune anomalie de santé n'a été attribuée au traitement dans aucune des études.


Asunto(s)
Enfermedades de los Gatos , Infestaciones por Ácaros , Ácaros , Animales , Enfermedades de los Gatos/tratamiento farmacológico , Gatos , Europa (Continente) , Ivermectina/análogos & derivados , Infestaciones por Ácaros/tratamiento farmacológico , Infestaciones por Ácaros/veterinaria , Praziquantel/uso terapéutico , Sudáfrica , Resultado del Tratamiento
4.
Parasite ; 28: 27, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33812459

RESUMEN

The therapeutic efficacy against notoedric mange of a topical combination of esafoxolaner, eprinomectin and praziquantel (Nexgard® Combo, Boehringer Ingelheim) was evaluated in a masked, controlled clinical study including 14 cats with natural or induced Notoedres cati infestation. Cats were allocated randomly to two groups of seven cats each, to be administered either mineral oil (placebo control) or NexGard® Combo. Each treatment was administered once as spot-on at 0.12 mL per kg body weight (representing the minimum label dosage of NexGard® Combo, i.e. 1.44 mg esafoxolaner, 0.48 mg eprinomectin, and 10.0 mg praziquantel per kg body weight). Live mites were counted in skin scrapings collected within seven days prior to and 14, 27/28, 42 and 56 days after treatment to calculate the percentage efficacy of NexGard® Combo based on the comparison of mean live mite counts of the two groups. Concurrently, mange lesions and clinical signs were scored to establish a clinical success valuation. No live mites were recovered from any NexGard® Combo-treated cats post-treatment, indicating 100% therapeutic efficacy following a single spot-on administration of the novel antiparasitic combination. The clinical success valuations in the NexGard® Combo-treated cats were 14.3%, 42.8%, 100% and 100% at 14, 27/28, 42 and 56 days after treatment, respectively. No health problems were observed throughout the study.


TITLE: Efficacité d'une nouvelle association topique d'esafoxolaner, d'éprinomectine et de praziquantel contre la gale à Notoedres cati chez le chat. ABSTRACT: L'efficacité thérapeutique contre la gale notoédrique d'une association topique d'esafoxolaner, d'éprinomectine et de praziquantel (Nexgard® Combo, Boehringer Ingelheim) a été évaluée dans une étude clinique contrôlée et masquée portant sur 14 chats atteints d'une infestation naturelle ou induite par Notoedres cati. Les chats ont été répartis au hasard en deux groupes de sept chats chacun, traités soit avec de l'huile minérale (contrôle placebo), soit avec NexGard® Combo. Chaque traitement a été administré en une seule fois à raison de 0,12 mL par kg de poids corporel (représentant la posologie minimale indiquée sur l'étiquette de NexGard® Combo, c'est-à-dire 1,44 mg d'esafoxolaner plus 0,48 mg d'éprinomectine plus 10,0 mg de praziquantel par kg de poids corporel). Les acariens vivants ont été comptés par grattage de peau et recueillis dans les sept jours précédant le traitement et 14, 27/28, 42 et 56 jours après le traitement pour calculer le pourcentage d'efficacité de NexGard® Combo basé sur la comparaison du nombre moyen d'acariens vivants des deux groupes. Parallèlement, les lésions de la gale et les signes cliniques ont été mesurés pour établir une évaluation du succès clinique. Aucun acarien vivant n'a été retrouvé chez les chats traités par NexGard® Combo après le traitement, ce qui indique une efficacité thérapeutique de 100% après une administration ponctuelle unique de la nouvelle association antiparasitaire. L'évaluation du succès clinique chez les chats traités par NexGard® Combo était de 14,3 %, 42,8 %, 100 % et 100 %, respectivement 14, 27/28, 42 et 56 jours après le traitement. Aucun problème de santé n'a été observé tout au long de l'étude.


Asunto(s)
Enfermedades de los Gatos , Infestaciones por Ácaros , Administración Tópica , Animales , Enfermedades de los Gatos/tratamiento farmacológico , Gatos , Ivermectina/análogos & derivados , Metopreno/uso terapéutico , Infestaciones por Ácaros/tratamiento farmacológico , Praziquantel/uso terapéutico , Pirazoles/uso terapéutico , Resultado del Tratamiento
5.
Parasit Vectors ; 11(1): 589, 2018 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-30449275

RESUMEN

BACKGROUND: A spot-on formulation containing fluralaner (280 mg/ml) plus moxidectin (14 mg/ml) (Bravecto® Plus) was developed for the treatment of nematode infections as well as providing 12 weeks of protection against insect and acarine parasites in cats. The effectiveness and safety of this product against feline gastrointestinal nematodes was assessed in naturally-infested, client-owned cats under field conditions in Albania, Bulgaria, Germany and Hungary. METHODS: To be eligible for enrollment in this investigator-blinded study cats had to be at least 10 weeks-old, weigh at least 1.2 kg, be clinically healthy, and have a faecal sample testing positive for nematodes no more than eight days prior to treatment. Cats were stratified into blocks of three in order of presentation at each center and randomly allocated in a 2:1 ratio to be treated topically on Day 0 with fluralaner plus moxidectin (minimum dose rates 40 mg/kg and 2 mg/kg, respectively) or emodepside plus praziquantel (minimum dose rates 3 mg/kg and 12 mg/kg, respectively) (Profender®). Faecal samples were collected from cats prior to treatment and 14 ± 4 days later. RESULTS: There were 182 cats randomized to the fluralaner plus moxidectin group, and 91 to the emodepside plus praziquantel group. Prior to treatment the most commonly identified nematode egg was Toxocara cati, found in 79.1 and 82.4% of cats in the fluralaner plus moxidectin and emodepside plus praziquantel groups, respectively. Eggs of Toxascaris leonina were found in 8.2 and 6.6% of cats; of hookworms in 30.8 and 24.2%; and of Capillaria spp. in 7.1 and 4.3%, respectively. After treatment, faecal samples from 98.3% of fluralaner plus moxidectin treated and 96.6% of emodepside plus praziquantel-treated cats were free of nematode ova. Geometric mean faecal egg count reductions for T. cati, the only eggs found in post-treatment faecal samples, were 99.97% and 99.93%, respectively. Treatment with fluralaner plus moxidectin was non-inferior to emodepside plus praziquantel. Both products were safe and well tolerated by cats treated under field conditions. CONCLUSIONS: This field study confirms that, in addition to 12-week extended duration flea and tick control, fluralaner plus moxidectin provides broad spectrum treatment of nematodes in cats.


Asunto(s)
Enfermedades de los Gatos/tratamiento farmacológico , Insecticidas/uso terapéutico , Isoxazoles/uso terapéutico , Macrólidos/uso terapéutico , Nematodos/efectos de los fármacos , Infecciones por Nematodos/veterinaria , Administración Tópica , Animales , Enfermedades de los Gatos/epidemiología , Enfermedades de los Gatos/parasitología , Gatos , Depsipéptidos/administración & dosificación , Depsipéptidos/efectos adversos , Depsipéptidos/uso terapéutico , Europa Oriental/epidemiología , Heces/parasitología , Femenino , Alemania/epidemiología , Insecticidas/administración & dosificación , Insecticidas/efectos adversos , Isoxazoles/administración & dosificación , Isoxazoles/efectos adversos , Macrólidos/administración & dosificación , Macrólidos/efectos adversos , Infecciones por Nematodos/tratamiento farmacológico , Infecciones por Nematodos/epidemiología , Infecciones por Nematodos/parasitología , Recuento de Huevos de Parásitos/veterinaria , Praziquantel/administración & dosificación , Praziquantel/efectos adversos , Praziquantel/uso terapéutico , Distribución Aleatoria , Método Simple Ciego , Siphonaptera/efectos de los fármacos , Siphonaptera/parasitología , Resultado del Tratamiento
6.
Parasitol Res ; 116(1): 259-269, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27771803

RESUMEN

Afoxolaner (AFX) plus milbemycin oxime (MO) combination chewable tablets (NexGard Spectra®, Merial) were evaluated for safety and efficacy against naturally acquired nematode infections in domestic dogs in a multi-centre, positive control, blinded field study using a randomized block design based on the order of presentation for allocation. In total, 408 dogs confirmed positive for naturally acquired infections of intestinal nematodes by pre-treatment faecal examination were studied in ten countries in Europe (Albania, Austria, Bulgaria, France, Germany, Hungary, Italy, Lithuania, Romania and Slovakia). Pre-treatment faecal examination revealed Toxocara, Toxascaris, hookworm, Trichuris and/or Capillaria nematode infections in 134, 30, 223, 155 and 14 dogs, respectively. Dogs were allocated to one of two treatment groups in a ratio of 1, AFX + MO chewables (≥2.5 mg AFX + ≥0.5 mg MO per kg body weight, according to dose bands; 207 dogs), and 1, MO plus praziquantel (PRZ) chewables (Milbemax®, Novartis; ≥0.5 mg MO + ≥5 mg PRZ per kg body weight, according to the manufacturer's instructions; 201 dogs) and treated once. For evaluation of efficacy based on reduction of faecal nematode egg counts, two faecal samples, one collected prior to treatment and one collected 9 to 21 days after treatment, were examined using modified McMaster techniques. For evaluation of systemic safety, dogs were examined by a veterinarian before treatment administration and at study end, and dog owners observed the health status of their dogs until the end of the study and reported any abnormal observation. For dogs treated with AFX + MO chewables, the efficacy was 99.7, 99.7, 97.2, 99.7 and 99.7 % for Toxocara, Toxascaris, hookworm, Trichuris and Capillaria, respectively; and the efficacy was 99.5, 99.4, 94.3, 99.9 and 98.0 %, respectively, for the MO + PRZ-treated dogs (p ≤ 0.002 for all nematodes and both treatments). For Toxocara, hookworm and Trichuris, non-inferiority analysis demonstrated that the efficacy of AFX + MO chewable tablets was equal to or better than that of MO + PRZ. In spite that both treatments were ≥98 % efficacious against Toxascaris and Capillaria, a hypothesis of non-inferiority for both genera could not be established due to the low number of dogs infected with these parasites. No treatment-related adverse experiences were observed throughout the study. For both treatments, all dogs were given a systemic safety score of 'excellent' apart from one dog in each treatment group which received a score of 'acceptable'. AFX + MO combination chewables were shown to be safe and demonstrated a high level of efficacy when administered once to dogs infected with a broad range of parasitic nematodes under field conditions.


Asunto(s)
Antinematodos/administración & dosificación , Enfermedades de los Perros/parasitología , Isoxazoles/administración & dosificación , Macrólidos/administración & dosificación , Naftalenos/administración & dosificación , Nematodos/efectos de los fármacos , Infecciones por Nematodos/veterinaria , Animales , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/epidemiología , Perros , Europa (Continente)/epidemiología , Heces/parasitología , Nematodos/fisiología , Infecciones por Nematodos/tratamiento farmacológico , Infecciones por Nematodos/parasitología , Praziquantel/uso terapéutico , Comprimidos/administración & dosificación , Resultado del Tratamiento
7.
Parasitol Res ; 113(11): 4303-6, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25258041

RESUMEN

The efficacy of a novel topical combination of fipronil 8.3% w/v, (S)-methoprene 10 % w/v, eprinomectin 0.4% w/v, and praziquantel 8.3% w/v (Broadline, Merial) was evaluated in 18 cats naturally infested by Notoedres cati in a controlled, blinded clinical efficacy study. Cats were blocked on pretreatment bodyweight and randomly allocated to two groups of nine cats each. One group served as control (untreated) and one group was treated once topically with Broadline according to the label instructions. Skin scrapings (three scrapings per animal per occasion) were collected prior to treatment and every other week for 8 weeks thereafter and examined for live N. cati mites. In addition, lesions were evaluated at each sampling to monitor the clinical recovery. Based on live mite counts, efficacy against N. cati of a single topical administration with Broadline was >99%, and all treated cats recovered from clinical signs of notoedric mange. No treatment-related adverse events were observed.


Asunto(s)
Antiparasitarios/uso terapéutico , Enfermedades de los Gatos/tratamiento farmacológico , Infestaciones por Ácaros/tratamiento farmacológico , Pirazoles/uso terapéutico , Administración Tópica , Animales , Antiparasitarios/administración & dosificación , Gatos , Combinación de Medicamentos , Femenino , Ivermectina/administración & dosificación , Ivermectina/análogos & derivados , Ivermectina/uso terapéutico , Masculino , Metopreno/administración & dosificación , Metopreno/uso terapéutico , Praziquantel/administración & dosificación , Praziquantel/uso terapéutico , Pirazoles/administración & dosificación , Sarcoptidae , Piel/parasitología
8.
Vet Parasitol ; 202(1-2): 10-7, 2014 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-24703070

RESUMEN

A novel topical combination product (BROADLINE(®), Merial) composed of fipronil, (S)-methoprene, eprinomectin and praziquantel was evaluated for safety and efficacy against nematode and cestode infections in domestic cats. The study comprised a multi-centre, positive control, blinded, field study, using a randomized block design based on order of presentation for allocation. In total 196 client-owned cats, confirmed as positive for naturally acquired infections of nematodes and/or cestodes by pre-treatment faecal examination, were studied in seven countries in Europe. Pre-treatment faecal examination revealed the presence of Toxocara, hookworm, Capillaria and/or spirurid nematode infections in 129, 73, 33 or 1 cat(s), respectively; infections with taeniid and Dipylidium cestodes were demonstrated in 39 and 17 cats, respectively. Cats were allocated randomly to one of two treatments in a ratio of 2, topical fipronil (8.3%, w/v), (S)-methoprene (10%, w/v), eprinomectin (0.4%, w/v) and praziquantel (8.3%, w/v) (BROADLINE(®), Merial; 130 cats); and 1, topical PROFENDER(®) Spot-On (Bayer; 66 cats) and treated once on Day 0. For evaluation of efficacy, two faecal samples were collected, one prior to treatment (Day -4 ± 4 days) and one at the end of the study (Day 14 ± 5 days). These were examined for fecal forms of nematode and cestode parasites. For evaluation of safety, cats were examined by a veterinarian before treatment and at the end of the study, and cat owners recorded the health status of their cats daily until the end of the study. For cats treated with Broadline(®), the efficacy was >99.9%, 100%, and 99.6% for Toxocara, hookworms, and Capillaria, respectively; and the efficacy was >99.9%, >99.9%, and 98.5%, respectively, for the cats treated with Profender(®) (p<0.001 for all nematodes and both treatments). Efficacy was 100% for both cestodes for both treatments (p<0.001). No treatment related adverse experiences were observed throughout the study. For both treatments, every cat that completed the study was given a safety score of 'excellent' for both local and systemic evaluations. The topical combination product of fipronil, (S)-methoprene, eprinomectin and praziquantel was shown to have an excellent safety profile and demonstrated high levels of efficacy when administered once as topical solution to cats infected with nematodes and cestodes under field conditions.


Asunto(s)
Enfermedades de los Gatos/tratamiento farmacológico , Infecciones por Cestodos/veterinaria , Ivermectina/análogos & derivados , Metopreno/administración & dosificación , Infecciones por Nematodos/veterinaria , Praziquantel/administración & dosificación , Pirazoles/administración & dosificación , Animales , Gatos , Cestodos , Infecciones por Cestodos/tratamiento farmacológico , Combinación de Medicamentos , Europa (Continente) , Femenino , Ivermectina/administración & dosificación , Masculino , Nematodos , Infecciones por Nematodos/tratamiento farmacológico , Resultado del Tratamiento
9.
Parasitol Res ; 112 Suppl 1: 57-66, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23760872

RESUMEN

Notoedric mange (feline scabies) is a rare, but highly contagious disease of cats and kittens caused by Notoedres cati (N. cati), which can infest other animals and also humans. The study objective was to determine the efficacy and safety of 10 % imidacloprid/ 1 % moxidectin (Advocate®/Advantage® Multi spot-on for cats) against natural N. cati infestation in cats. Sixteen cats were randomly assigned to treatment group or negative control using pre-treatment mite counts. The treatment group received a single spot on treatment of the investigational veterinary product (IVP) according to label instructions. The control group stayed untreated. Five cats from the negative control were treated with the IVP at the end of the study and observed for 28 days to increase the treatment group. Skin scrapings and mite counts were performed 28 days post treatment (p.t.). Notoedric skin lesion assessments with clinical scoring were performed regularly. Five animals had to be removed prematurely from the study population due to different reasons. The number of viable N. cati mites in all treated animals 28 days p.t. was zero compared with 2.8 ± 3.0 in the negative control, being significantly lower for treated cats (p = 0.0019, Wilcoxon test). The resulting efficacy was 100 %. Clinical cure based on skin lesion assessment was achieved 28 days p.t. in 100 % of all treated animals completing 28 study days. The IVP was well tolerated and applied at the minimal therapeutic dose (10 mg imidacloprid/1 mg moxidectin/kg body weight) a high therapeutic efficacy in curing N. cati infestations and feline scabies clinical symptoms was recorded.


Asunto(s)
Acaricidas/uso terapéutico , Enfermedades de los Gatos/tratamiento farmacológico , Imidazoles/uso terapéutico , Macrólidos/uso terapéutico , Infestaciones por Ácaros/veterinaria , Nitrocompuestos/uso terapéutico , Sarcoptidae/efectos de los fármacos , Acaricidas/efectos adversos , Administración Tópica , Animales , Gatos , Combinación de Medicamentos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Imidazoles/efectos adversos , Macrólidos/efectos adversos , Infestaciones por Ácaros/tratamiento farmacológico , Infestaciones por Ácaros/parasitología , Neonicotinoides , Nitrocompuestos/efectos adversos , Carga de Parásitos , Piel/parasitología , Piel/patología , Resultado del Tratamiento
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