Comparative clinical studies of nitazoxanide, albendazole and praziquantel in the treatment of ascariasis, trichuriasis and hymenolepiasis in children from Peru

Abstract

Three randomized clinical studies were conducted in 2000 to evaluate the efficacy of nitazoxanide paediatric suspension compared to albendazole in the treatment of ascariasis and trichuriasis and praziquantel in the treatment of hymenolepiasis in children from Cajamarca, Peru. Nitazoxanide was administered at a dose of 100 mg (age 1-3 years) or 200 mg (age 4-11 years) twice daily for 3 days, albendazole as a 400-mg single dose and praziquantel as a 25-mg/kg single dose. Post-treatment parasitological examinations were carried out on 3 faecal samples, each collected on a different day between 21 and 30 days following initiation of treatment. Nitazoxanide cured 89% (25/28), 89% (16/18) and 82% (32/39) of the cases of ascariasis, trichuriasis and hymenolepiasis respectively compared with 91% (32/35), 58% (11/19) and 96% (47/49) for the comparator drugs. Each of the drugs produced egg reduction rates in excess of 98%. There were no significant adverse events or abnormalities in haematology or clinical chemistry values or urinalysis.

Antiparasitic Drug Nitazoxanide Inhibits the Pyruvate Oxidoreductases of Helicobacter pylori , Selected Anaerobic Bacteria and Parasites, and Campylobacter jejuni

“…NTZ is a broad-spectrum antiparasitic drug that also exhibits toxicity against a range of anaerobic bacteria, microaerophiles, and some viruses (5,8,20,21,22,27). To test whether PFOR is a general target of NTZ, cellular extracts were prepared from each of the organisms listed in Table 1, and PFOR activities were measured anaerobically by monitoring the reduction of BV at 546 nm or the change in the absorbance at 418 nm for NTZ.…”

“…We propose that NTZ ؊ intercepts PFOR at an early step in the formation of the lactyl-TPP transition intermediate, resulting in the reversal of pyruvate binding prior to decarboxylation and in coordination with proton transfer to NTZ. Thus, NTZ might be the first example of an antimicrobial that targets the "activated cofactor" of an enzymatic reaction rather than its substrate or catalytic sites, a novel mechanism that may escape mutation-based drug resistance.Nitazoxanide [2-acetyloxy-N-(5-nitro-2-thiazolyl) benzamide] (NTZ) is a broad-spectrum drug that is efficacious for the treatment of infections caused by amitochondriate luminal parasites and helminths (8,15,21,26) and that shows promise as an alternative therapy for treating infections caused by Clostridium difficile (20). More generally, NTZ appears to be an effective treatment for persistent diarrhea (35) and even infections caused by rotavirus (26).…”

“…Nitazoxanide [2-acetyloxy-N-(5-nitro-2-thiazolyl) benzamide] (NTZ) is a broad-spectrum drug that is efficacious for the treatment of infections caused by amitochondriate luminal parasites and helminths (8,15,21,26) and that shows promise as an alternative therapy for treating infections caused by Clostridium difficile (20). More generally, NTZ appears to be an effective treatment for persistent diarrhea (35) and even infections caused by rotavirus (26).…”

Nitazoxanide: Nematicidal mode of action and drug combination studies

“…This drug is considered safe and is the mainstay for the treatment of Cryptosporidia infections in immuno-compromised individuals and patients with Acquired Immune Deficiency Syndrome (AIDS) [25–28]. Serendipitously, NTZ was found to be effective against nematode parasites [29–32] which encouraged several investigations on NTZ’s therapeutic effects on different species of parasitic worms. Reports suggest that NTZ is effective in treating a number of parasitic nematodes, e.g.…”

Using a health-rating system to evaluate the usefulness of Caenorhabditis elegans as a model for anthelmintic study

“…Nitazoxanide was found to be effective in treatments against various bacterial infections and as an antiviral agent [19]. Rather surprisingly, nitazoxanide was recently found to be effective in treating STHs [20–23]. The primary drug used for MDA is albendazole because of its low cost of production and wide efficacy against microfilariae and adult helminths.…”