Giardiasis medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
The drug [[tinidazole]] has a long half life and a single dose of 2000 mg is effective in 90% of patients. This obviates the longer treatment using the other medications listed. The shorter duration of treatment may also cause less patient distress. Tinidazole is now approved by the FDA and available to U.S. patients. Tinidazole is approved for the treatment of Giardiasis in patients over three years of age. If a child is unable to swallow the tablets, they can be crushed and mixed with a favorite food or with syrup. Side effects of tinidazole include [[nausea]], [[vomiting]], [[headache]], the development of a metallic taste in the mouth and [[disulfiram]]-like side effects. Gatrointestinal side effects can be minimized by taking tinidazole with food. | The drug [[tinidazole]] has a long half life and a single dose of 2000 mg is effective in 90% of patients. This obviates the longer treatment using the other medications listed. The shorter duration of treatment may also cause less patient distress. Tinidazole is now approved by the FDA and available to U.S. patients. Tinidazole is approved for the treatment of Giardiasis in patients over three years of age. If a child is unable to swallow the tablets, they can be crushed and mixed with a favorite food or with syrup. Side effects of tinidazole include [[nausea]], [[vomiting]], [[headache]], the development of a metallic taste in the mouth and [[disulfiram]]-like side effects. Gatrointestinal side effects can be minimized by taking tinidazole with food. | ||
===Antimicrobial regimen=== | |||
::* 1.1 '''Adult''' | |||
:::* Preferred regimen (1): [[Metronidazole]] 250 mg tid 5–7 days | |||
:::* Preferred regimen (2): [[Tinidazole]] 2 g single dose | |||
:::* Preferred regimen (3): [[Nitazoxanide]] 500 mg PO bid (with food) | |||
:::* Alternative regimen (1): [[Paromomycin]] 500 mg tid 3 5–10 days | |||
:::* Alternative regimen (2): [[Quinacrine]] 100 mg tid 3 5–7 days | |||
:::* Alternative regimen (3): [[Furazolidone]] 100 mg qid 3 7–10 days | |||
::* 1.2 '''Pediatric''' | |||
:::* Preferred regimen (1): [[Metronidazole]] 5 mg/kg tid 3 5–7 days | |||
:::* Preferred regimen (2): [[Tinidazole]] 50 mg/kg single dose (max, 2 g) | |||
:::* Preferred regimen (3): [[Nitazoxanide]] 100 mg PO bid for age 1-3 years or 200 mg PO bid for age 4-11 years (with food) | |||
:::* Alternative regimen (1): [[Paromomycin]] 30 mg/kg/day in 3 doses 3 5–10 days | |||
:::* Alternative regimen (2): [[Quinacrine]] 2 mg/kg tid 3 7 days | |||
:::* Alternative regimen (3): [[Furazolidone]] 2 mg/kg qid 3 10 days | |||
==References== | ==References== | ||
Revision as of 18:23, 10 August 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Drugs used to treat adults include metronidazole, albendazole and quinacrine. Furazolidone and nitazoxanide may be used in children. Treatment is not always necessary, as the body can defeat the infection by itself.
Medical Therapy
The drug tinidazole has a long half life and a single dose of 2000 mg is effective in 90% of patients. This obviates the longer treatment using the other medications listed. The shorter duration of treatment may also cause less patient distress. Tinidazole is now approved by the FDA and available to U.S. patients. Tinidazole is approved for the treatment of Giardiasis in patients over three years of age. If a child is unable to swallow the tablets, they can be crushed and mixed with a favorite food or with syrup. Side effects of tinidazole include nausea, vomiting, headache, the development of a metallic taste in the mouth and disulfiram-like side effects. Gatrointestinal side effects can be minimized by taking tinidazole with food.
Antimicrobial regimen
- 1.1 Adult
- Preferred regimen (1): Metronidazole 250 mg tid 5–7 days
- Preferred regimen (2): Tinidazole 2 g single dose
- Preferred regimen (3): Nitazoxanide 500 mg PO bid (with food)
- Alternative regimen (1): Paromomycin 500 mg tid 3 5–10 days
- Alternative regimen (2): Quinacrine 100 mg tid 3 5–7 days
- Alternative regimen (3): Furazolidone 100 mg qid 3 7–10 days
- 1.2 Pediatric
- Preferred regimen (1): Metronidazole 5 mg/kg tid 3 5–7 days
- Preferred regimen (2): Tinidazole 50 mg/kg single dose (max, 2 g)
- Preferred regimen (3): Nitazoxanide 100 mg PO bid for age 1-3 years or 200 mg PO bid for age 4-11 years (with food)
- Alternative regimen (1): Paromomycin 30 mg/kg/day in 3 doses 3 5–10 days
- Alternative regimen (2): Quinacrine 2 mg/kg tid 3 7 days
- Alternative regimen (3): Furazolidone 2 mg/kg qid 3 10 days