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One of the key challenges in the effective control of parasitic infections is the emergence of drug resistance, which threatens to undermine the efficacy of available treatments such as oral ivermectin. The selective pressure exerted by widespread use and suboptimal dosing regimens can accelerate the development of resistance in parasite populations, necessitating proactive surveillance and management strategies. Combination therapies, drug rotation, and integrated vector management approaches are among the strategies proposed to mitigate the risk of resistance and preserve the effectiveness of stromectol and other antiparasitic drugs.