First Report of Resistance to Ivermectin in Parascaris univalens in Iceland.

Horses in Iceland have been isolated for more than 1,000 yr but still harbor a similar range of gastrointestinal parasites as do horses across the world. The long isolation of the horses and their parasites presumably means that no resistance genes have been introduced into the Parascaris spp. population. It is therefore of particular interest to investigate the efficacy of ivermectin on Parascaris spp. infecting Icelandic foals. Potential treatment failure of ivermectin in Iceland will add substantial new information on how resistance can arise independently. This study aimed to determine the efficacy of subcutaneous injection of ivermectin for the treatment of Parascaris spp. infection in foals and to identify the Parascaris species present in the west and north of Iceland. A fecal egg count reduction (FECR) test (FECRT) was performed on 50 foals from 8 farms, including an untreated control group of 6 foals, from September to November 2019. The foals were between 3 and 5 mo of age at the start of the study and had not previously been treated with anthelmintic drugs. Each foal was treated subcutaneously with off-label use of Ivomec® injection 10 mg/ml or Noromectin® 1% at a dose of 0.2 mg/kg. The FECR for each farm was calculated in 2 ways, by the eggCounts package in R and by the Presidente formula (FECRT). Both calculation methods resulted in efficacy levels between 0% and 80.78%, indicating ivermectin resistance on all farms. We also confirmed, by karyotyping, that the species of equine ascarid present in the west and north of Iceland is Parascaris univalens. This study provides evidence for treatment failure of ivermectin against P. univalens infection in foals. Since Icelandic horses have been isolated on the island for more than 1,000 yr, this implies that resistance alleles have developed independently in the Icelandic Parascaris population. The actual clinical impact of ivermectin resistance is unknown but another drug of choice should be considered to treat Parascaris infection in foals in Iceland.

Unusual case of lagochilascariasis with breast involvement: the first case report in pregnancy.

Lagochilascariasis is a neglected neotropical helminthiasis, responsible for human infections through the ingestion of raw or undercooked meat from wild animals infected by larvae encysted in their tissues. It is characterized by a chronic evolution with periods of remission and recurrences, affecting mainly the head and neck regions. It can progress to death by invasion of the central nervous system. It is caused by the Lagochilascaris minor nematode, first described in 1909 and mainly found in the Brazilian Amazon ecosystem, notably in Para State. In May 2010, a 15-year-old female, born in the city of Aveiro, Para State, was hospitalized in the city of Santarem, Para State, presenting with cervical and spinal abscesses and osteolytic lesions at T3-T5 level. During hospitalization, white larvae identified as L. minor were observed in a cervical subcutaneous fistula. After the surgical drainage of abscesses, albendazole 400 mg/day was started, with improvement of symptoms. The patient abandoned the follow-up and in January 2016, during the 20th week of pregnancy, she was readmitted to the Santarem Municipal Hospital with new cervical abscesses in the infra-mammary region, with numerous larvae exiting by subcutaneous left breast fistulas. The antiparasitic treatment was restarted due to possible reactivation of the infection in the spine and dissemination to the central nervous system. Ten weeks after hospital discharge, the patient had resolution of the fistulas and decreased abscesses, without gestational complications. This is the first case report of lagochilascariasis during pregnancy, as well as of involvement of mammary glands.

The P-glycoprotein repertoire of the equine parasitic nematode Parascaris univalens.

P-glycoproteins (Pgp) have been proposed as contributors to the widespread macrocyclic lactone (ML) resistance in several nematode species including a major pathogen of foals, Parascaris univalens. Using new and available RNA-seq data, ten different genomic loci encoding Pgps were identified and characterized by transcriptome-guided RT-PCRs and Sanger sequencing. Phylogenetic analysis revealed an ascarid-specific Pgp lineage, Pgp-18, as well as two paralogues of Pgp-11 and Pgp-16. Comparative gene expression analyses in P. univalens and Caenorhabditis elegans show that the intestine is the major site of expression but individual gene expression patterns were not conserved between the two nematodes. In P. univalens, PunPgp-9, PunPgp-11.1 and PunPgp-16.2 consistently exhibited the highest expression level in two independent transcriptome data sets. Using RNA-Seq, no significant upregulation of any Pgp was detected following in vitro incubation of adult P. univalens with ivermectin suggesting that drug-induced upregulation is not the mechanism of Pgp-mediated ML resistance. Expression and functional analyses of PunPgp-2 and PunPgp-9 in Saccharomyces cerevisiae provide evidence for an interaction with ketoconazole and ivermectin, but not thiabendazole. Overall, this study established reliable reference gene models with significantly improved annotation for the P. univalens Pgp repertoire and provides a foundation for a better understanding of Pgp-mediated anthelmintic resistance.

Reduced efficacy of ivermectin and moxidectin against Parascaris spp. in foals from Argentina.

Macrocyclic lactones are the most widely used drugs for the control of gastrointestinal nematodes of horses in Argentina. Ivermectin and moxidectin are used as broad spectrum anthelmintics and although there are several international reports on the resistance of Parascaris spp., the resistance status of the local nematode population is largely unknow. This report informs a case of suboptimal efficacy to both drugs to control Parascaris spp in foals in central Argentina. In February 2018, routine fecal parasite egg counts showed a moderate-high number of Parascaris spp eggs (mean = 680 eggs per gram of feces) in foals treated approximately one month before with moxidectin. Upon suspicion of resistance of this parasite to the macrocyclic lactones, 24 of these animals were selected for a fecal egg count reduction test (FECRT). Twelve foals were treated with ivermectin and the remaining 12 animals with moxidectin. Two weeks after treatment, the FECRT was 48.1% and 34.8% for moxidectin and ivermectin respectively (25% of the animals increased the number of eggs in feces after treatment). Five days later, the administration of fenbendazole resulted in a FECRT = 100%. The monitoring of the status of susceptibility or resistance in each establishment is critical for the design of control programs based on rational and sustainable use of anthelmintics.

Efficacy of a new oral chewable tablet containing sarolaner, moxidectin and pyrantel (Simparica Trio™) against induced ascarid infections in dogs.

BACKGROUND: Ascarid infections are among the most prevalent intestinal parasitic infections occurring in dogs around the world, with Toxocara canis and Toxascaris leonina commonly observed. Toxocara canis can cause considerable disease in dogs and humans, and year-round prophylactic treatment and control in dogs is recommended. Elimination of immature stages of these parasites before egg-laying will reduce environmental contamination and the risk of infection for both dogs and humans. Studies were conducted to evaluate the efficacy of a novel, oral chewable tablet containing sarolaner, moxidectin and pyrantel (Simparica Trio™) against induced immature adult (L5) and adult T. canis, and adult T. leonina infections in dogs. METHODS: Six negative-controlled, masked, randomized laboratory studies were conducted. Two studies each evaluated efficacy against immature adult (L5) T. canis, adult T. canis, and adult T. leonina. Sixteen to 40 dogs were included in each study. Dogs experimentally infected with the target parasite were dosed once on Day 0 with either placebo tablets or Simparica Trio™ tablets to provide minimum dosages of 1.2 mg/kg sarolaner, 24 µg/kg moxidectin and 5.0 mg/kg pyrantel (as pamoate salt). Efficacy was based on the number of worms recovered at necropsy 7-10 days after treatment compared to placebo control. RESULTS: Based on geometric mean worm counts, efficacy of the sarolaner + moxidectin + pyrantel combination was ≥ 95.2% against immature adult T. canis, ≥ 97.3% against adult T. canis, and ≥ 89.7% against adult T. leonina. There were no treatment-related adverse events in any study. CONCLUSIONS: These studies confirm the efficacy of a single dose of a new oral chewable tablet containing sarolaner, moxidectin and pyrantel (Simparica Trio™) against immature adult and adult T. canis, and adult T. leonina infections in dogs.

Lagochilascaris minor (Nematoda, Ascarididae) in a domestic cat in a coastal city of the state of São Paulo.

This paper describes the discovery of Lagochilascaris minor parasitizing a stray cat (Felis catus) in São Sebastião, a coastal city in the state of São Paulo, Brazil. The cat presented fistulas with purulent secretion in the ventral cervical region. A thorough evaluation revealed nematodes in the site. The parasites were removed, amounting to a total of about 100 specimens. The parasite species was identified based on measurements and morphological characteristics of adult worms. This report of parasitism by L. minor in domestic cats in the state of São Paulo reinforces the need for greater attention to this parasitosis, given the increase in cases among carnivores in Brazil.

Nodular Human Lagochilascariasis Lesion in Hunter, Brazil.

Lagochilascariasis is a rare helminthic infection caused by Lagochilascaris minor nematodes and found in Latin America; most cases are reported in the Amazon region. We report on a case observed in a hunter in southern Brazil and describe scanning electron microscopy results for L. minor adult forms.

Risk factors for equine intestinal parasite infections and reduced efficacy of pyrantel embonate against Parascaris sp.

Gastrointestinal parasites, Parascaris sp. and strongyles, are common in young horses worldwide and control of these parasites is challenged by increasing anthelmintic resistance. Our aim was to identify risk factors for these infections as well as to assess the efficacy of fenbendazole (dose 7.5 mg/kg) and pyrantel embonate (dose 19 mg/kg) against Parascaris sp. We also evaluated association between owner observed symptoms and patent infections with these parasites. Fecal samples were collected from 367 young horses in Finland and a questionnaire study was conducted. Fecal egg counts were performed by Mini-FLOTAC® method. Univariable logistic regression models using patent infection status (Yes/No), separately for Parascaris sp. and strongyle infections as an outcome were run initially to screen potential risk factors collected by the questionnaire. After the initial screening, multiple logistic regression models were constructed and run to account for correlated data structure, risk factors and potential confounders simultaneously. Two significant risk factors for a patent Parascaris sp. infection were found: breeding farm size (p = 0.028) and frequency of horse movements (p = 0.010). Horses originating from large breeding farms were more likely (OR = 2.47, 95% confidence interval (CI) 1.10-5.51) to shed Parascaris sp. eggs upon relocation to training stables compared to horses originating from small breeding farms. Horses living in farms with frequent horse movements to other premises had higher odds (OR = 3.56, 95% CI: 1.35-9.39) of a patent Parascaris sp. infection compared to farms with less frequent horse movements. Risk factors for patent strongyle infection included age (p < 0.001) and season (p = 0.017). Horses were less likely (OR = 0.27, 95% CI: 0.10 - 0.66) to shed strongylid eggs during the spring compared to the winter. Horses excreting over 200 ascarid eggs per gram were included in the anthelmintic efficacy trial. A mean FECR less than 90% was interpreted as presence of anthelmintic resistance. The mean FECR was 98.5% (95% CI: 95.8-100) and 68.0% (95% CI: 52.7-83.3) in the fenbendazole (n = 31) and pyrantel (n = 26) treatment groups, respectively. In conclusion, we identified two new risk factors for patent Parascaris sp. infection; breeding farm size and frequency of horse movements. Reduced efficacy of pyrantel against Parascaris sp. was observed for the second time in Europe. A relatively high Parascaris sp. prevalence in yearlings (34%) and two-year-olds (20%) was observed, which has not been reported earlier. An association between symptoms and a patent Parascaris sp. infection was observed in foals.

The application of faecal egg count results and statistical inference for clinical decision making in foals.

This study investigated the impact of variability in Parascaris spp. and strongyle faecal egg counts (FEC) from foals on treatment decision-making and detection of a patent infection. A single faecal sample was collected once daily for three days from 53 foals and a FEC was performed on three separate portions of each sample (total of nine egg counts per foal). Differences in the decision to administer an anthelmintic using the results of a single count (C1), the mean of three (X¯1-3) or nine counts (X¯1-9) and the upper 5% confidence limit of the gamma confidence interval (CI) of the estimate of the distribution mean (µ) from three (UCL1-3) and nine counts (UCL1-9) were determined for a range of egg count thresholds. The UCL1-9 was used as the best estimate of µ, hypothesis testing for treatment and the comparison of treatment decision-making using C1, X¯1-3, X¯1-9 and UCL1-3. The results of this study demonstrated that a point estimate (C1 or X¯1-3) was of limited value for estimating the distribution mean of egg counts in faeces and there was overall poor agreement in treatment decision-making for individual foals using C1 compared with UCL1-9. Of the foals with C1 of zero eggs per gram, 54% and 47% had Parascaris and strongyle eggs in subsequent counts, respectively. The egg density in faeces is inhomogeneous, resulting in considerable variability in egg count results for an individual foal: between faecal piles, different portions of a faecal pile and days. The use of the negative binomial distribution CI for µ takes this variability into account and is recommended for use when interpreting FEC data from horses.

Anthelmintic efficacy of single active and combination products against commonly occurring parasites in foals.

Parasite control in foals is complicated by the concurrent presence of biologically diverse parasites with differing levels of anthelmintic resistance. Several combination anthelmintic products are available for use in horses, but information on their efficacies against important equine parasites is scarce. Two trials were performed in New Zealand during 2008 and 2011 on four different farms with substantially different anthelmintic treatment histories. The first trial evaluated the efficacy of an ivermectin/praziquantel/oxibendazole combination, a single active oxibendazole, and a single-active macrocyclic lactone (ML) in 49 foals located on three farms. The second trial evaluated two combination anthelmintic products and three single-active ML products and enrolled a total of 110 foals on three farms. Foals in the second trial were allocated to one of six anthelmintic treatment groups; oxfendazole/pyrantel embonate, pyrantel embonate/ivermectin/praziquantel, ivermectin/praziquantel, abamectin/praziquantel, moxidectin/praziquantel, and a placebo-treated control. In both trials, foals were monitored monthly prior to treatment, and fecal egg counts (FECs) of Parascaris spp., strongylid, and Strongyloides westeri were determined. A "rolling enrolment" process was implemented whereby foals were systematically allocated to a treatment group and treated with the corresponding anthelmintic following the first appearance of Parascaris spp. eggs in the faeces. A generalised linear model was used to evaluate the effect of farm and treatment on Day14 FEC (ln) for each parasite. Three different FECR calculation methods were employed as follows; i) FECR(T) pre and post treatment ii) FECR (C) in the treated group compared with control, and iii) FECR (P) pre- and post- treatment in the treated and control groups. Across both trials, treatment with ML single active products failed to achieve >95% reduction in Parascaris spp. FEC on two of three farms. The pyrantel embonate/oxfendazole and ivermectin/ praziquantel/oxibendazole combinations demonstrated full efficacy against Parascaris spp. This is in contrast to the anti-strongylid efficacies determined, where the pyrantel embonate/oxfendazole combination and single active oxibendazole had reduced efficacy on one farm, while the macrocyclic lactones generally had good efficacy. Strongyloides egg counts were sporadic in both trials, and allowed limited insight into anthelmintic efficacy. The study illustrated the importance of keeping an untreated or placebo-treated control group in studies evaluating anti-Parascaris efficacy and it demonstrated the utility of a rolling enrolment procedure, where foals are enrolled over the course of a defined period of time. Furthermore, the study demonstrated the value of a farm specific FECR monitoring programme and the complexity of parasite control in foals, where combination anthelmintic products can be employed to target multiple species of parasites.

Baylisascaris procyonis Central Nervous System Infection in a Four-Month-Old Gordon Setter Dog.

A 16 wk old intact female Gordon setter was examined for a 2 wk history of progressive cerebellovestibular ataxia. Eosinophilia was found on complete blood count, and the remaining blood work was normal. A trial treatment with clindamycin and anti-inflammatory prednisone did not result in improvement of clinical signs; therefore, the dog was euthanized. On histopathologic examination, cross sections of a 75 µm wide nematode larva with a 5 µm cuticle, prominent lateral cords, lateral alae, and coeloemyelian musculature were identified in a focally extensive region of cerebellar necrosis. The size and morphology of the parasites was most consistent with Baylisascaris procyonis. This case highlights a rare but important zoonotic disease that should be considered as a differential diagnosis in any dog exhibiting acute, progressive central nervous system signs, and peripheral eosinophilia. The index of suspicion should be elevated in dogs with an unknown deworming history and known or suspected exposure to raccoons. Because most anthelminthics have been shown to be effective against B. procyonis, annual deworming is recommended in the at-risk population to reduce the likelihood of aberrant migration and zoonosis.

Resistance to pyrantel embonate and efficacy of fenbendazole in Parascaris univalens on Swedish stud farms.

The aims of this study were to determine the species of Parascaris present in foals in Sweden and to establish whether anthelmintic resistance to pyrantel and fenbendazole is present on Swedish stud farms. Ascarid eggs collected from different regions in Sweden were karyotyped and were all identified as Parascaris univalens, characterized by one chromosomal pair. Faecal egg count reduction tests were performed on a total of 142 foals on 9 farms between September 2016 and May 2017. Healthy foals with at least 150 eggs per gram faeces (EPG) were included in the study and treated with oral pastes of pyrantel embonate or fenbendazole according to manufacturer instructions. The efficacy of the drugs was calculated by a Bayesian model using the R package "eggCounts". In accordance with the American Association of Equine Practitioners, parasites were classified as resistant to pyrantel if the reduction in EPG was ≤ 85% and to fenbendazole if the observed efficacy was ≤ 90%. Four of eleven groups treated with pyrantel had an observed efficacy of ≤ 85%, and as many as 43% of the foals treated with pyrantel excreted eggs 10-16 days after treatment. In contrast, one of the six groups treated with fenbendazole had an observed efficacy of ≤ 90%, and only 6% of all foals were excreting eggs 10-16 days after treatment. Since resistance to ivermectin has earlier been shown to be widespread in Parascaris spp. in Sweden it is likely that multiresistant populations are present on Swedish stud farms. This is the first study showing the existence of pyrantel-resistant Parascaris spp. in Europe, and the first ever study where anthelmintic resistance has been shown in P. univalens.

Rapid Therapeutic Response of Eosinophilic Meningoencephalitis in a Toddler With Baylisascaris procyonis Infection.

INTRODUCTION: Eosinophilic meningitis is an infrequently encountered condition. Baylisascaris procyonis (raccoon roundworm) infection, rarely diagnosed in North America, is a known cause of eosinophilic meningitis, often producing death or permanent neurologic damage. CASE REPORT: We recently encountered a toddler with geophagia and probable exposure to raccoon feces, who presented with eosinophilic meningitis and encephalitis, and was diagnosed with B procyonis infection and possible Toxocara co-infection. His marked peripheral eosinophilia and neurologic symptoms rapidly responded to corticosteroid and albendazole therapy. DISCUSSION: Since B procyonis infection is infrequently encountered, its diagnosis in the proper clinical and epidemiologic setting may not always be considered, resulting in a delay of appropriate therapy. Our patient, diagnosed and treated early in his course, demonstrated rapid clinical and laboratory improvement with anti-inflammatory and antiparasitic therapy. CONCLUSION: In cases of eosinophilic meningitis, infection with B procyonis should be routinely considered to allow timely institution of effective therapy for this unusual but potentially fatal or debilitating infection.

Characteristics of parasitic egg shedding over a 1-year period in foals and their dams in 2 farms in central Saskatchewan.

The goals of this study were to report the seasonal shedding patterns of strongyle and Parascaris spp. eggs in repeated fecal samples for mares (n = 38) and foals (n = 39), and to evaluate the efficacy of ivermectin treatment in mares from 2 selected horse breeding farms in central Saskatchewan. Median strongyle fecal egg counts (FEC) peaked in July and August in adult horses. The farms differed significantly (P = 0.0005) in regard to strongyle shedding categories (< 200; 200 to 500; and > 500 eggs/g) over time, but for each individual horse (both farms combined) these categories did not differ over time (P = 0.13) on samples collected in grazing season. When evaluating 3 samples collected fall, summer and fall in 2 consecutive grazing seasons, 94% of horses that shed < 200 eggs/g on 2 initial samples, remained in the same category on the third sample. Mares on each farm didn't differ statistically in shedding categories when comparing September samples from 2 consecutive years (Farm A: P = 0.56, Farm B: P = 0.06). Peak strongyle shedding occurred late fall in the first year of life for foals on Farm A, and in July in the second year of life for foals on Farm B. Parascaris spp. FEC were greatest in foals ≤ 6 months of age, with peak observed when foals were 5 to 6 months old. Ivermectin was 100% effective at reducing strongyle FEC 2 weeks after treatment in adult horses. Horses in Saskatchewan had relatively high strongyle shedding levels, which were significantly different between the farms, and high prevalence of Oxyuris equi. Strongyle shedding consistency was observed for FECs collected from mares in grazing season (July to September).

Caractéristiques de l'excrétion des oeufs de parasites pendant une période de 1 an chez les poulains et leurs mères dans deux fermes du centre de la Saskatchewan. Cette étude avait pour but de dresser un rapport sur les tendances d'excrétion saisonnière des oeufs des strongyles et de Parascaris spp. dans des prélèvements fécaux répétés pour les juments (n = 38) et les poulains (n = 39) et d'évaluer l'efficacité du traitement à l'ivermectine chez deux juments provenant de deux fermes d'élevage de chevaux dans le centre de la Saskatchewan. Les comptes médians d'oeufs fécaux des strongyles ont culminé en juillet et en août chez les chevaux adultes. Les fermes présentaient des différences significatives (P = 0,0005) à l'égard des catégories d'excrétion des strongyles (< 200; de 200 à 500; et > 500 oeufs/g) dans le temps, mais, pour chaque cheval individuel (les deux fermes combinées), ces catégories ne présentaient pas de différences à la longue (P = 0,13) pour les échantillons prélevés durant la saison de pâturage. Lors de l'évaluation des reois échantillons prélevés à l'automne, à l'été et à l'automne pendant deux saisons de pâturage consécutives, 94 % des chevaux qui avaient excrété < 200 oeufs/g pour deux prélèvements initiaux, sont demeurés dans la même catégorie pour le troisième échantillon. Les juments de chaque ferme ne présentaient pas de différences statistiques pour les catégories d'excrétion lorsque l'on comparait les échantillons de septembre provenant de deux années consécutives (Ferme A : P = 0,56, Ferme B : P = 0,06). L'excrétion des strongyles a culminé à la fin de l'automne pendant la première année de vie pour les poulains de la Ferme A et en juillet de la deuxième année de vie pour les poulains de la Ferme B. Les comptes d'oeufs fécaux de Parascaris spp. étaient les plus importants chez les poulains âgés de ≤ 6 mois et le point culminant était observé lorsque les poulains étaient âgés de 5 ou 6 mois. L'ivermectine était efficace à 100 % pour réduire les comptes d'oeufs fécaux 2 semaines après le traitement chez les chevaux adultes. Les chevaux de la Saskatchewan ont présenté des taux d'excrétion relativement élevés de strongyles, qui étaient significativement différents entre les fermes, et une forte prévalence d'Oxyuris equi. La constance de l'excrétion des strongyles a été observée pour les comptes d'oeufs fécaux obtenus auprès des juments pendant la saison de pâturage (de juillet à septembre).(Traduit par Isabelle Vallières).

A field study on the anthelmintic resistance of Parascaris spp. in Arab foals in the Riyadh region, Saudi Arabia.

BACKGROUND: In the last decade, Parascaris spp. resistance to anthelmintics has been recorded in many countries. In Saudi Arabia, there are limited data available on Parascaris spp. resistance to anthelmintics. OBJECTIVE: To determine the current status of ivermectin, abamectin and praziquantel combined, and fenbendazole resistance to Parascaris spp. in horses in Saudi Arabia. METHODS: Three hundred and forty-one foals from eleven different farms were examined by faecal egg count (FEC). The foals were all Arab horses aged 17.2 ± 4.5 (SD) months. Ivermectin (n = 46 foals), abamectin and praziquantel combined (n = 46), and fenbendazole (n = 46) were administered on day 0 and faeces were collected on day 14. The study comprised 41 untreated foals as controls. Animals that have FEC of ≥100 eggs per gram (EPG) were used to measure anthelmintic efficacy. Parascaris spp. populations were considered susceptible when faecal egg count reduction (FECR) was ≥95% associated with a lower 95% confidence limit (LCL) >90%, suspected resistant when FECR ≤90% or LCL <90% and resistant when FECR <90% and LCL <90%. RESULTS: Prevalence of Parascaris spp. infection was 53% (179/341 horses). Anthelmintic resistance to Parascaris spp. were highest following fenbendazole (55% of farms and 65% of foals) and to a lower extent following ivermectin or the combination of abamectin and praziquantel which comprised 27% of farms (and 46% of foals) and 18% of farms (and 10% of foals), respectively. CONCLUSION: These data indicate that anthelmintics-resistant Parascaris spp. populations are present on horse farms in Saudi Arabia.

Managing anthelmintic resistance in Parascaris spp.: A modelling exercise.

A previously described model for the dynamics of the parasitic stages of Parascaris spp. was modified to include eggs outside the host and the genetics of anthelmintic resistance before being used to address questions regarding the development of resistance. Three broad questions were addressed; i) How sustainable is the current common practice of treating foals monthly for their first year of life (i.e. 12 treatments/year)? ii) Does the timing of treatments have an effect on resistance development? (i.e. do certain treatments select for resistance more strongly than others?), and iii) How sustainable is the currently recommended strategy of targeting ascarid infections in foals with two treatments applied during the first five months of life? A range of variations within these broad questions were considered, such as the value in rotational deworming, whether larvicidal treatments are more selective for resistance, and whether combination anthelmintics should be introduced. Twelve anthelmintic treatments at monthly intervals resulted in the development of resistance to all the anthelmintics used, regardless of how they were used, indicating that such intensive treatment frequency is unlikely to be sustainable. The timing of a single annual treatment influenced resistance development with treatments at 3 and 4 months of age being more selective than treatments at other times. Treatments administered to foals older than 6 months of age did not select for resistance within the timeframe of these simulations. Treatments with activity against migrating third stage larvae (ivermectin and a programme of 5 daily treatments with fenbendazole) were more selective for resistance than those which only killed worms in the intestine. Restricting the number of treatments to young foals to two, administered at 2 and 5 months of age slowed the development of resistance by allowing a small contribution from susceptible genotype worms to subsequent generations. If the interval between treatments was reduced, resistance developed more rapidly demonstrating the importance of allowing some susceptible worms to reach patency before the second treatment is administered. Under a reduced treatment schedule with a clearly defined 'refugium' of susceptibility, the use of effective actives in combination appears to offer advantages for delaying resistance development. The model offers insights into more sustainable drug use strategies and has identified some priority questions for future research.

Efficacy of a morantel-abamectin combination for the treatment of resistant ascarids in foals.

BACKGROUND: This study was performed to investigate the efficacy of a morantel-abamectin combination for the treatment of macrocyclic lactone (ML)-resistant Parascaris spp. infections in foals. METHODS: Foals on five properties with a Parascaris faecal egg count (FEC) > 50 eggs per gram were used to estimate the FEC reduction (FECR) and efficacy of the anthelmintic combination. RESULTS & CONCLUSION: On all properties, resistance to ivermectin and abamectin was present and the Parascaris FECR in foals administered the morantel-abamectin combination was > 99%, indicating that this combination effectively controlled ML-resistant parasites.