Synergistic in vitro effects of albendazole and minocycline on the viability of hydatid cyst protoscoleces

Hydatid disease poses a major zoonotic threat, affecting human health and livestock. Although albendazole is the standard treatment, it may cause adverse effects at high serum levels. This study investigated the protoscolicidal efficacy of minocycline alone and in combination with albendazole, compared to albendazole monotherapy, on hydatid cyst protoscoleces from sheep liver. Protoscoleces were aseptically aspirated from the sheep livers containing hydatid cysts. A total of 30,000 protoscoleces were suspended in 300 µl of normal saline and exposed to various concentrations of minocycline (10, 25, 50, 75, 125, 250, and 500 µg/ml) and albendazole (31.25, 62.5, 125, 250, 500, 1000, and 2000 µg/ml) for 10, 30, and 60 min, and subsequently from 1 h up to 43 h of incubation, in triplicate. The viability of the protoscoleces was assessed using 0.1 % eosin staining. The combination of Minocycline and Albendazole significantly reduced protoscoleces viability (P < 0.05). All the treatment groups demonstrated progressive reductions in cell viability over time. Notably, combination therapy reduced viability to zero at 22 h, wherase Albendazole and Minocycline alone reached 0 % and 1.3 % viability, respectively, at 43 h. The combination of minocycline and albendazole produced significantly, partially, stronger scolicidal activity than either monotherapy, achieving complete protoscolex mortality within ∼22 h compared with 43 h for albendazole and incomplete killing with minocycline alone (P < 0.05). These findings suggest that this drug combination may enhance treatment efficacy for hydatid disease and warrants further in vivo evaluation.