In Vitro Effects of Artemether, Artemisinine, Albendazole, and Their Combinations on Echinococcus granolosus Protoscoleces

Hydatidosis caused by Echinococcus granulosusus remains an important parasitic disease, mainly in the Mediterranean region, in human and veterinary medicine. Many protoscolicidal agents have been used to treat it, but most of them are not safe and effective due to their undesirable side effects. The aim of the present work was to evaluate the in vitro efficacy of the antihelminths artemether, artemisinine, albendazole, and drug combinations against Echinococcus granulosusus protoscoleces. Echinococcus granulosus protoscoleces were aseptically removed from liver hydatid cysts in sheep. Drugs were used at the following final concentrations: 1, 2.5, 5, 10, 25, 50, 100, and 200 μg/mL for 15 days. The viability of protoscoleces was confirmed by Eosine 0.1%. In this case, the protoscolicidal effect of artemether and its combinations was significantly (P < 0.05) higher than other groups; the maximum protoscolicidal effect was found with 200 μg/mL of artemether after 4 days whereas albendazole killed protoscoleces on the 7th day post-incubation. Surprisingly, the incubation of protoscoleces with artemisinine exhibited promising results, as only artemisinine was more effective against evaginated protoscoleces on the 9th day. The maximum effect of two drugs combined belonged to artemether and artemisinine. The obtained outcome demonstrated the desirable effect of artemether against Echinococcus granulosus protoscoleces. With regard to artemisinine’s astonishing results, it seems that artemisinine can be a striking drug for tissue and metacestode forms of hydatidosis in human and animal models. However, further investigations into the in vivo experiments are proposed.