Empirical therapy for hepatic lesions in suspected clonorchiasis: a comparative efficacy analysis of Albendazole and Praziquantel.

Background: Clonorchiasis frequently presents as intrahepatic space-occupying lesions, posing a diagnostic challenge due to the low sensitivity of fecal examination. While Praziquantel is the standard first-line therapy, Albendazole is often used empirically in suspected cases. However, the comparative efficacy of these two agents across different levels of diagnostic certainty (confirmed vs. suspected) remains poorly defined. Methods: This retrospective cohort study included 151 patients with clonorchiasis-related hepatic lesions treated at our institution between January 2018 and December 2025. Patients were categorized into a Praziquantel group ( Results: The overall clinical cure rate was higher in the Praziquantel group (76.9%, 60/78) than in the Albendazole group (67.1%, 49/73), though the difference was not statistically significant ( Conclusion: The efficacy of Albendazole in treating clonorchiasis-related hepatic lesions is modulated by diagnostic certainty. While Praziquantel remains the superior choice for confirmed cases, Albendazole demonstrates comparable clinical efficacy in stool-negative suspected cases. These findings indicate that Albendazole demonstrates similar lesion resolution to Praziquantel in stool-negative suspected cases. However, given the retrospective design, these results should be interpreted as hypothesis-generating, necessitating prospective trials for confirmation.