Infection with Echinococcus granulosus is endemic in Middle Eastern countries. Some patients are noted to undergo spontaneous resolution, but many require surgical removal with its associated risks. Although, there are studies showing favourable responses to medical treatment, there is no controlled study on the effect of
albendazole. In this study, 20 patients with 179 E. granulosus
cysts affecting the lungs were entered into a triple blind parallel randomized clinical trial comparing the effects of
albendazole versus placebo. Fifteen patients (150
cysts) completed 6 months of treatment; four patients (26
cysts) were in the placebo group and 11 patients (124
cysts) in the treatment group receiving 800 mg
albendazole daily in three cycles of 6 weeks with 2 weeks between cycles. Ten of 11 patients (91%) in the treatment group showed either cure (five patients) or improvement (five patients); in the placebo group, only one of four (25%) showed spontaneous improvement but no cure. In the treatment group, 88 of 124
cysts (71%) showed improvement compared to four of 26 (15.4%) in the placebo group (p=0.000). Complication from
therapy was insignificant; one case had recurrent disease, which responded to further
therapy. It is suggested that patients suffering from uncomplicated
hydatid disease should be given a trial of
albendazole before surgery is considered.