No effective approved drug therapy exists for Cryptosporidium infection of immunocompromised patients.Here we investigated the nonabsorbed anthelmintic drug pyrvinium pamoate for inhibition of the growth of the intestinal protozoan parasite Cryptosporidium parvum. The concentration of pyrvinium that effected 50% growth inhibition in human enterocytic HCT-8 cells by a quantitative alkaline phosphatase immunoassay was 354 nM. For comparison, in the same assay, 50% growth inhibition was obtained with 711 M paromomycin or 27 M chloroquine. We used a neonatal mouse model to measure the anti-Cryptosporidium activity of pyrvinium pamoate in vivo. Beginning 3 days after infection, pyrvinium at 5 or 12.5 mg/kg of body weight/day was administered to the treatment group mice for 4 or 6 consecutive days. Nine days after infection, the mice were sacrificed, and drug efficacy was determined by comparing the numbers of oocysts in the fecal smears of treated versus untreated mice. The intensities of trophozoite infection in the ileocecal intestinal regions were also compared using hematoxylin-and-eosin-stained histological slides. We observed a >90% reduction in infection intensity in pyrvinium-treated mice relative to that in untreated controls, along with a substantial reduction in tissue pathology. Based on these results, pyrvinium pamoate is a potential drug candidate for the treatment of cryptosporidiosis in both immunocompetent and immunocompromised individuals.Cryptosporidium is an important apicomplexan protozoan pathogen that contributes significantly to diarrheal disease in both humans and animals throughout the world (9, 10, 21). In immunocompetent hosts, infections are generally restricted to the intestinal epithelium, causing an acute, self-limiting gastroenteritis. However, in AIDS patients and other immunocompromised individuals, infection can result in life-threatening, chronic diarrhea and may spread to extraintestinal locations (16,26). Although the efficacies of numerous antimicrobial agents against Cryptosporidium infection have been tested using animal and cell culture models, there is currently no reliably effective therapeutic for the treatment of chronic cryptosporidiosis in immunocompromised patients (30).Recently, nitazoxanide (NTZ), a nitrothiazole benzamide, was approved by the FDA for the treatment of cryptosporidiosis in immunocompetent adults and children aged Ͼ1 year (2). However, while clinical studies are ongoing, the efficacy of NTZ for the treatment of Cryptosporidium infection in immunocompromised patients has not yet been demonstrated (1). A 50% inhibitory concentration (IC 50 ) of 3.8 M has been reported for NTZ in cell culture (12). In a neonatal mouse model, oral administration of NTZ at 150 mg/kg of body weight reduced oocyst output to less than 5% of that seen in controls (6); however, NTZ at 100 or 200 mg/kg was ineffective at reducing parasite burdens in a SCID mouse model (24).Prior to the FDA approval of NTZ as an anti-Cryptosporidium therapeutic, the glycoside antibiotic paromomyc...