Five v Ten Days' Therapy With Furazolidone for Giardiasis

Murphy, Trudy V.; Nelson, John D.

doi:10.1001/archpedi.1983.02140290053014

Cited by 13 publications

(10 citation statements)

References 10 publications

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“…Also, this drug is currently the recommended agent in therapy for giardiasis in infants and young children, since there exists a pediatric suspension form and cure rates are higher due to better acceptability (4). Although the published data offer various results as to the relative effectiveness of furazolidone, quinacrine, and metronidazole in therapy for giardiasis, all three are effective in more than 80% of cases (1,4,14,18,19). Furazolidone may be active against certain forms of bacteremic salmonellosis (10,12) …”

Section: Resultsmentioning

confidence: 99%

Furazolidone versus ampicillin in the treatment of traveler's diarrhea

DuPont¹,

Ericsson²,

Galindo³

et al. 1984

Antimicrob Agents Chemother

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Ninety-four U.S. students who acquired diarrhea in Mexico were treated with furazolidone (47 subjects) or ampicillin (47 subjects) on a double-blind random basis. Of 47 students, 26 (55%) who received furazolidone (100 mg four times daily for 5 days) recovered from illness wit-hin 48 h after initiation of therapy, in contrast to 15 of 47 (32%) who received ampicillin (500 mg four times daily for 5 days) (P < 0.05). Altogether, 74% of students treated with furazolidone and 49% of those receiving ampicillin were well within 72 h (P < 0.05). When furazolidone was compared with ampicillin, clinical illness was shortened on the average from 65 to 61 h for enterotoxigenic Escherichia coli diarrhea, from 83 to 58 h for shigellosis, fromn 82 to 51 h for diarrhea unassociated with a detectable agent, and from 72 to 57 h for all cases irrespective of etiology. Although not dramatically effective in the current trial, the broad spectrum of activity of furazolidone is of interest. Because of in vitro activity against Campylobacter strains and known effectiveness in treating giardiasis, furazolidone should be considered in therapy for diarrhea of unknown etiology in certain settings when laboratory processing of stools for etiological agent is not feasible.

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Section: Resultsmentioning

confidence: 99%

Furazolidone versus ampicillin in the treatment of traveler's diarrhea

DuPont¹,

Ericsson²,

Galindo³

et al. 1984

Antimicrob Agents Chemother

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“…The proportion of study participants who had symptoms varied. For example, diarrhoea at the start of therapy was reported in just under a quarter of participants in the study by Suntornpoch and Chavalittamrong (1981), compared to all participants in the study by Murphy and Nelson (1983). Abdominal pain was reported by 30% of patients in the study by Gazder and Banerjee (1977), and in 95% of patients in the study of Gupta et al (1989).…”

Section: Characteristics Of Included Trialsmentioning

confidence: 91%

A systematic review on the treatment of giardiasis

Zaat¹,

Mank

Assendelft³

1997

Tropical Med Int Health

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SummaryTo assess the efficacy of treatment of parasitological excretion of cysts and trophozoites and symptoms of patients with giardiasis, a systematic review of published randomized clinicial trials was conducted through extensive searches in Medline, Embase and Current Contents from 1966 till 1996 as well as manual reviews of 28 journals. The methodological quality of all trials was assessed by guidelines of the Cochrane Collaboration. Thirty-one trials were included, only one of which had no serious methodological flaws. The mean score of parasitological examination was 4.8 out of a possible 15. There was a considerable effect in cure rate of treatment versus placebo (odds 9.3, 95%CI 4.69-18.4), but all 3 trials in this comparison had serious flaws. Metronidazole treatment over more than 3 days seems to achieve a better parasitological cure rate than other long treatment courses (pooled odds 2.6, 95% 1.7-3.8), but trials are clinically and statistically heterogeneous. Single-dose therapy is as effective as longer treatment courses (pooled odds 0.67, 95% 0.31-1.44). Within the single-dose regimens tinidazole (2 g) reaches a higher parasitological cure rate than other short therapies (pooled odds 55, 95% CI 3.7-8.3) with relatively few side-effects. Placebo-controlled trials with parasitological and clincial outcomes are needed.

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“…Although its efficacy has generally been considered to be slightly lower than those of metronidazole and quinacrine, curative rates between 80 and 96% have been reported for 7-to 10-day courses (Table 1) (20,52,91,151,178,191,201,255). It is when the drug is given for only 5 days that efficacy falls off considerably (151,178). It is given as four doses per day in both adults (100 mg per dose) and children (1.5 mg/kg) ( Table 2).…”

Section: Classes Of Agents and Clinical Propertiesmentioning

confidence: 99%

“…Clinically resistant strains have been treated with longer repeat courses or higher doses of the original agent (91,165,178). However, the most efficacious means of eradicating these infections seems to involve using a drug from a different class to avoid potential cross-resistance (52,92).…”

Section: Special Situationsmentioning

confidence: 99%

Treatment of Giardiasis

2001

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Giardia lamblia is both the most common intestinal parasite in the United States and a frequent cause of diarrheal illness throughout the world. In spite of its recognition as an important human pathogen, there have been relatively few agents used in therapy. This paper discusses each class of drugs used in treatment, along with their mechanism of action, in vitro and clinical efficacy, and side effects and contraindications. Recommendations are made for the preferred treatment in different clinical situations. The greatest clinical experience is with the nitroimidazole drugs, i.e., metronidazole, tinidazole, and ornidazole, which are highly effective. A 5- to 7-day course of metronidazole can be expected to cure over 90% of individuals, and a single dose of tinidazole or ornidazole will cure a similar number. Quinacrine, which is no longer produced in the United States, has excellent efficacy but may be poorly tolerated, especially in children. Furazolidone is an effective alternative but must be administered four times a day for 7 to 10 days. Paromomycin may be used during early pregnancy, because it is not systematically absorbed, but it is not always effective. Patients who have resistant infection can usually be cured by a prolonged course of treatment with a combination of a nitroimidazole with quinacrine

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Five v Ten Days' Therapy With Furazolidone for Giardiasis

Cited by 13 publications

References 10 publications

Furazolidone versus ampicillin in the treatment of traveler's diarrhea

Furazolidone versus ampicillin in the treatment of traveler's diarrhea

A systematic review on the treatment of giardiasis

Treatment of Giardiasis

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