Furazolidone in the treatment of giardiasis

Webster, B. H.

doi:10.1007/bf02290195

Cited by 5 publications

(2 citation statements)

References 6 publications

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“…It is effective against many bacteria including Klebsiella spp., Clostridium spp., Escherichia coli, Campylobacter spp., and Staphylococcus aureus. As early as the 1950s, furazolidone was being used in the treatment of giardiasis (253). It is approved for use in the United States and remains an important therapeutic agent worldwide.…”

Section: Classes Of Agents and Clinical Propertiesmentioning

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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Section: Classes Of Agents and Clinical Propertiesmentioning

confidence: 99%

Treatment of Giardiasis

2001

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“…Although the eradication of viable vibrios occurred almost identically fast in the two groups, the group of patients receiving furazolidone for 3 days showed somewhat earlier cessation of diarrhea, lower stool volume, and higher rate of stopping diarrhea by 72 h after start of treatment than the patients treated once with a single dose. This slight advantage of the 3-day regimen for the clinical course of diarrhea could be the result of an earlier or more complete cessation of cholera toxin production by bacteria after exposure to furazolidone or of therapeutic effects of furazolidone in the larger dose on other intestinal bacteria, including Campylobacter spp., or the intestinal protozoan Giardia lamblia (2,9,10,21), which in some patients may have been copathogens.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a single dose of furazolidone for treatment of cholera in children

Rabbani

Butler

Shahrier

et al. 1991

Antimicrob Agents Chemother

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To test the efficacy and safety of furazolidone given as a single dose for childhood cholera, a randomized double-blind placebo-controlled trial was carried out among 118 culture-positive dehydrated children with diarrhea. Patients were randomly assigned to one of four groups to receive medication orally in liquid suspension: furazolidone at 7 mg/kg/day once, furazolidone at 7 mg/kg/day divided into four doses for 3 days, placebo once, or placebo for 3 days. After 12 patients with furazolidone-resistant infections were excluded from the analysis of efficacy, it was determined that both groups treated with furazolidone showed significantly higher rates of bacteriologic success (stool cultures negative for Vibrio cholerae on days 2 to 4 after start of therapy) and clinical success (cessation of diarrhea within 72 h after start of therapy) than corresponding placebo groups (P < 0.001). There were no significant differences between responses to the 3-day and single-dose regimens of furazolidone, but there was a trend toward better clinical responses in patients who received furazolidone for 3 days. No patient treated with furazolidone dropped out because of side effects. These results indicate that furazolidone, given as either a single dose or divided doses for 3 days, is effective treatment for childhood cholera.Cholera is an acute illness caused by an enterotoxin produced by Vibrio cholerae that have colonized in the small bowel. In its most severe form, there is rapid loss of fluid and electrolytes from the gastrointestinal tract, resulting in hypovolemic shock, metabolic acidosis, and, if untreated, death (20). Cholera remains one of the diarrheal diseases with significant mortality in many developing countries (4). Fluid replacement is the most important component of therapy. While antibiotics are not essential to the treatment of the disease, they do shorten the duration of excretion of vibrios, the duration and volume of diarrhea, and the amount of fluid replacement required (5). Tetracycline is the antibiotic of choice for the treatment of cholera, and consideration of alternative drugs has been confined to the treatment of pregnant women and children for whom tetracycline was contraindicated because it stains developing teeth (8). Additionally, in areas such as Bangladesh, where multiply antibiotic-resistant V. cholerae have emerged, an alternative treatment must be considered (11).Furazolidone is effective in the treatment of cholera when given in multiple doses or single daily doses for 3 to 7 days (7,8,14,17 Treatment and clinical observations. After selection for the study, patients were allocated to one of four treatment groups according to a computer-generated list of random numbers. The treatments consisted of liquid suspensions of (i) furazolidone (7 mg/kg/day) given as a single dose on day 1, (ii) placebo liquid suspension given as a single dose on day 1, (iii) furazolidone (7 mg/kg/day) given in four equal daily doses on days 1, 2, and 3, and (iv) placebo liquid suspension given in four equal dai...

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