Albendazole versus metronidazole in the treatment of adult giardiasis: a randomized, double-blind, clinical trial

Cañete, Roberto; Rodríguez, Pablo Segado; Mesa, Lumey; Brito, Katia; Prior, Ada; Guilhem, Dirce; Novaes, María Rita Carvalho Garbi

doi:10.1185/03007995.2011.637915

Cited by 8 publications

(5 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 46% frequency of metronidazole refractory giardiasis is considerably higher than the 15% found in a randomized clinical trial carried out in Matanzas in 2009 [14]. Patients treated for G. intestinalis infection in the past month were excluded from the 2009 study, which probably accounts for part of the difference.…”

Section: Discussionmentioning

confidence: 88%

“…In Cuba, giardiasis is typically treated with 5-nitroimidazoles. Failure rates with metronidazole and secnidazole were approximately 15% and 10%, respectively, in studies conducted in 2009 and 2010 [13,14]. 5-Nitroimidazole refractory giardiasis appears to have increased in Matanzas during the last few years, though this has not been studied.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

5-Nitroimidazole refractory giardiasis is common in Matanzas, Cuba and effectively treated by secnidazole plus high-dose mebendazole or quinacrine: a prospective observational cohort study

Cañete¹,

Noda

Rodríguez

et al. 2020

Clinical Microbiology and Infection

View full text Add to dashboard Cite

Objective: To evaluate the effectiveness and tolerability of secnidazole combined with high-dose mebendazole for treatment of 5-nitroimidazole-resistant giardiasis. Method: Adults with microscopically verified Giardia intestinalis monoinfection attending a secondary level hospital in Matanzas City, Cuba were prospectively included in a cohort. A recently introduced treatment ladder consisting of metronidazole as first-line treatment, followed by secnidazole, tinidazole, secnidazole plus mebendazole and quinacrine as second-to fifth-line treatments, respectively, was used. Adverse events and treatment success were determined by questioning and microscopy on concentrated stool samples, respectively on days 3, 5 and 7 after the end of treatment. If G. intestinalis was detected on day 3, 5 or 7, then the infection was classified as refractory and no further microscopy was performed. Results: A total of 456 individuals were included. Metronidazole, 500 mg three times daily for 5 days, cured 248/456 (54%) patients. A single 2-g secnidazole dose as second-line treatment cured 50/208 (24%) patients. A single 2-g tinidazole dose as third-line treatment cured 43/158 (27%) patients. Three rounds of 5-nitroimidazole therapy therefore cured 341/456 (75%) patients. Secnidazole plus mebendazole (200 mg every 8 hours for 3 days) cured 100/115 (87%) of nitroimidazole refractory infections. Quinacrine cured the remaining 15 patients. All treatments were well tolerated. Conclusions: 5-Nitroimidazole refractory giardiasis was common, indicating that an alternative first-line treatment may be needed. Retreatment of metronidazole refractory giardiasis with an alternative 5nitroimidazole was suboptimal, indicating cross-resistance. Mebendazole plus secnidazole were well tolerated and effective for the treatment of 5-nitroimidazole refractory G. intestinalis infection in this setting.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

5-Nitroimidazole refractory giardiasis is common in Matanzas, Cuba and effectively treated by secnidazole plus high-dose mebendazole or quinacrine: a prospective observational cohort study

Cañete¹,

Noda

Rodríguez

et al. 2020

Clinical Microbiology and Infection

View full text Add to dashboard Cite

show abstract

“…Metronidazole is the drug of choice against giardiasis, but is not 100% effective and may produce undesirable side effects such as headaches and metallic taste in the mouth [ 37 ]. It has also been shown to be mutagenic and teratogenic in laboratory animals [ 38 , 39 ]. The search for antiparasitic agents in marine organisms is extensive, however, there are few reports about the effects of venoms from sea anemones and jellyfish against bacteria and parasites [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Hemolytic, anticancer and antigiardial activity of Palythoa caribaeorum venom

Lazcano-Pérez

Zavala-Moreno

Rufino-González

et al. 2018

J Venom Anim Toxins Incl Trop Dis

View full text Add to dashboard Cite

BackgroundCnidarian venoms and extracts have shown a broad variety of biological activities including cytotoxic, antibacterial and antitumoral effects. Most of these studied extracts were obtained from sea anemones or jellyfish. The present study aimed to determine the toxic activity and assess the antitumor and antiparasitic potential of Palythoa caribaeorum venom by evaluating its in vitro toxicity on several models including human tumor cell lines and against the parasite Giardia intestinalis.MethodsThe presence of cytolysins and vasoconstrictor activity of P. caribaeorum venom were determined by hemolysis, PLA2 and isolated rat aortic ring assays, respectively. The cytotoxic effect was tested on HCT-15 (human colorectal adenocarcinoma), MCF-7 (human mammary adenocarcinoma), K562 (human chronic myelogenous leukemia), U251 (human glyoblastoma), PC-3 (human prostatic adenocarcinoma) and SKLU-1 (human lung adenocarcinoma). An in vivo toxicity assay was performed with crickets and the antiparasitic assay was performed against G. intestinalis at 24 h of incubation.ResultsP. caribaeorum venom produced hemolytic and PLA2 activity and showed specific cytotoxicity against U251 and SKLU-1 cell lines, with approximately 50% growing inhibition. The venom was toxic to insects and showed activity against G. intestinalis in a dose-dependent manner by possibly altering its membrane osmotic equilibrium.ConclusionThese results suggest that P. caribaeorum venom contains compounds with potential therapeutic value against microorganisms and cancer.

show abstract

“…Metronidazole remains the first-line treatment for some infections related to inflammatory disorders of the gastrointestinal tract such as Clostridium difficile [9,35,36]. The side effects of metronidazole include nausea, vomiting, diarrhea, abdomen pain, abdominal cramping, headache, dizziness, and weakness [37][38][39][40][41]. also, it may lead to neurotoxicity, peripheral neuropathy, encephalopathy, and optic neuropathy in some cases [40,[42][43][44][45].…”

Section: Introductionmentioning

confidence: 99%

Metronidazole-induced Metallic Taste: A Systematic Review and Meta-Analysis

Karrar¹,

Nouh

Alhendi

et al. 2021

JPRI

View full text Add to dashboard Cite

Aims: This study aimed to estimate the incidence rate of metallic taste side effects in a patient who received metronidazole versus tinidazole and link it to the safety profile for metronidazole. Study Design: Systematic Review and Meta-Analysis. Place and Duration of Study: This study where written and revised in the pharmaceutical care department at general network for healthcare providers Hospital, Jeddah, Saudi Arabia. between Mar 2021 and Dec 2021. Methodology: Literature searches were conducted in the following databases: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Statistical analysis was performed using Review Manager (RevMan) Version 5.4 software. Results: Our meta-analysis of randomized controlled trials studies confirm that there is a slight increase in the rate of metallic taste adverse effects. Around one-fifth of patients who were treated with tinidazole had developed an incidence rate (5.1%) higher than the patient who treated with metronidazole. Our data shows that the incidence rate of metallic taste adverse effects in patients who received metronidazole was 15.5% (58/373) while the incidence rate in patients who received tinidazole was 20.6% (104/505). But the overall rate of metallic taste adverse effects was not statistically significantly different (RR, 1.07; 95% CI, 0.45 to 2.55; P = 0.87). also, there was statistical heterogeneity in the included studies (I2 = 75%). Conclusion: In our meta-analysis, the incidence rate of metronidazole-associated metallic taste adverse effects was slightly lower than the incidence rate of tinidazole-associated metallic taste adverse effects. It is not statistically significant as the result shows but still shifting the patient to metronidazole instead of tinidazole may decrease the incidence rate of metallic taste by (5.1%) and give good coverage for the microbial than tinidazole.

show abstract

Albendazole versus metronidazole in the treatment of adult giardiasis: a randomized, double-blind, clinical trial

Abstract: ABZ was found as effective as MTZ in the treatment of G. duodenalis infections in adult patients from Cuba and could be a useful drug in areas where co-infection with STH infections is common.

Cited by 8 publications

References 28 publications

5-Nitroimidazole refractory giardiasis is common in Matanzas, Cuba and effectively treated by secnidazole plus high-dose mebendazole or quinacrine: a prospective observational cohort study

5-Nitroimidazole refractory giardiasis is common in Matanzas, Cuba and effectively treated by secnidazole plus high-dose mebendazole or quinacrine: a prospective observational cohort study

Hemolytic, anticancer and antigiardial activity of Palythoa caribaeorum venom

Metronidazole-induced Metallic Taste: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About