What is the drug of choice for treating Necator americanus (hookworm) infection?

• A. Ivermectin
• B. Mebendazole
• C. Albendazole
• D. Praziquantel

Answer: (C)

Hookworm infections are best treated with a drug that is highly effective against both adult worms and migrating larvae and can be given in a simple regimen. Albendazole fits this well: it’s a benzimidazole that disrupts microtubule formation in nematodes, blocking glucose uptake and energy production, which immobilizes and kills the worms. For Necator americanus, a single 400 mg dose of albendazole achieves high cure rates and is convenient for patients, making it the preferred first-line therapy. Mebendazole can also treat hookworm but is generally less effective, so albendazole is favored. Praziquantel targets trematodes and cestodes, not nematodes, so it’s not used for hookworm. Ivermectin is effective against many parasites, including some helminths, but albendazole has superior efficacy for hookworm and is commonly preferred as the initial choice.