Comparative Study between the Effect of Nitazoxanide and Paromomycine in Treatment of Cryptosporidiosis in Hospitalized Children

Understanding drug resistance in human intestinal protozoa

“…It reduces parasite load and shorten the duration of cryptosporidial diarrhea in immunocompetent individuals (Hussien et al 2013). In contrast to extracellular protozoa, the nitro group is not required for the activity of nitazoxanide against Cryptosporidium parvum, implying a different mechanism of action (Gargala et al 2010).…”

“…Treatment of immunosuppressed patients is remarkably difficult even with higher doses and longer duration of treatment (Kelly 2011). Paromomycin and azithromycin are partially effective, and they are not routinely prescribed as anti-cryptosporidial agents in practice (Kappagoda et al 2011;Hussien et al 2013). The use of highly active antiretroviral therapy (HAART) in HIVinfected patients is associated with dramatic improvement of cryptosporidial diarrhea.…”

Treatment of Cryptosporidium: What We Know, Gaps, and the Way Forward

“…However, there has been little clinical advancement in the treatment of cryptosporidiosis. The study conducted by Hussien et al concluded that nitazoxanide treatment is superior to paromomycin in children with chronic diarrhea in endemic areas [30]. Successful development of novel drugs could also aid in decreasing childhood malnutrition.…”

“…A recent study among hospitalized children in Egypt aged 6 months to 10 years presenting with persistent diarrhea compared paromomycin and nitazoxanide with no antiparasitic treatment. [30]. Overall, 86.6% of children treated with 100 or 200 mg of nitazoxanide every twelve hours for three days demonstrated complete clearance of oocysts and cessation of clinical symptoms.…”

“…While Hussien et al demonstrated clearance of cryptosporidiosis among hospitalized children with paromomycin treatment compared to no treatment. However, the response was significantly less active than with nitazoxanide [30]. …”