Cryptosporidiosis medical therapy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
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Medical Therapy
- Supportive care:
- Supportive management of diarrhea should be by advising patients to drink plenty of fluids to prevent dehydration. People who are in poor health or who have weakened immune systems are at higher risk for more severe and prolonged illness. Young children and pregnant women may be more susceptible to dehydration resulting from diarrhea and should drink plenty of fluids while ill. Rapid loss of fluids from diarrhea may be especially life threatening to babies. Therefore, parents should talk to their health care providers about fluid replacement therapy options for infants.
- Symptomatic therapy with anti-motility agents and a tincture of opium are preferred over loperamide.
- Nitazoxanide has been FDA-approved for treatment of diarrhea caused by Cryptosporidium in people with healthy immune systems and is available by prescription. However, the effectiveness of nitazoxanide in immunosuppressed individuals is unclear.
- HIV-positive individuals who suspect they have cryptosporidiosis should contact their health care provider. For those persons with AIDS, anti retroviral therapy that improves the immune status will also decrease or eliminate symptoms of cryptosporidiosis. However, even if symptoms disappear, cryptosporidiosis is often not curable and the symptoms may return if the immune status worsens.
- Medical Therapy
- 1. Immunocompetent[1]
- Preferred regimen: No specific therapy recommended since healthy patients usually recover within a few weeks, but if needed: Nitazoxanide 500 mg PO bid for 3 days.
- 2. HIV[2]
- Preferred regimen: Nitazoxanide 500 mg PO bid for 3 days
- 3. HIV and Immunodeficiency[3]
- No pharmacologic or immunologic therapy directed specifically against Cryptosporidium has been shown to be consistently effective when used without ART
- In patients with severe immunosuppression antiretroviral therapy must be initiated immediately and the goal for CD4 cells should be greater than 100cells/mm³. This alone will result in the resolution of the clinical symptoms.
- Note: Nitazoxanide is not licensed for immunodeficient patients
External Link
http://www.cdc.gov/parasites/crypto/treatment.html
References
- ↑ Rossignol JF, Ayoub A, Ayers MS (2001). "Treatment of diarrhea caused by Cryptosporidium parvum: a prospective randomized, double-blind, placebo-controlled study of Nitazoxanide". J Infect Dis. 184 (1): 103–6. doi:10.1086/321008. PMID 11398117.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.