Strongyloides stercoralis prophylaxis in immunocompromised adults without HIV infection

This section includes regimens for antimicrobial prophylaxis and pre-emptive treatment of Strongyloides stercoralis in immunocompromised adults without HIV infection.

For treatment of symptomatic S. stercoralis infection, see Strongyloidiasis.

Perform baseline Strongyloides serology in patients with a past or present epidemiological risk of acquiring S. stercoralis—ie those who were born, live in or visit endemic areas. This includes patients from tropical or central Australia or remote Aboriginal and Torres Strait Islander communities, as well as older patients from southern European countries, and refugees and migrants from developing countries.

For pre-emptive treatment in asymptomatic immunocompromised adults with positive Strongyloides serology, use:

Immunocompromised patients who live in or visit a Strongyloides-endemic area (eg remote Aboriginal and Torres Strait Islander communities) should receive ongoing prophylaxis; use:

S. stercoralis prophylaxis is recommended for patients with significant immunosuppression and negative Strongyloides serology who live in or visit a Strongyloides-endemic area (eg remote Aboriginal and Torres Strait Islander communities). In this circumstance, significant immunosuppression is defined as use of prednisolone 20 mg daily or more (or equivalent; see Corticosteroid doses approximately equivalent to prednisolone 20 mg daily) for more than 2 weeks, or any other potent immunosuppressive drug (eg used for chemotherapy or following organ transplant). Use:

Immunocompromised patients who live in or visit a Strongyloides-endemic area (eg remote Aboriginal and Torres Strait Islander communities) should receive ongoing prophylaxis; use: