Table 1.
Giardiasis after nitroimidazole failure: patient characteristics, combination therapy schemes, and outcome
| Patient | Age/sex | Underlying disease | Previous drugs* | Combination treatment scheme† | Outcome |
|---|---|---|---|---|---|
| Type of patient | |||||
| Origin | Follow-up‡ (duration) | ||||
| 1 | 28/M | None | MTZ: 5 (21 g) | MTZ × 10 d + | Clinical improvement |
| Immigrant | TDZ: 1 (2 g) | ABZ × 10 d + | Negative stool test | ||
| Syria | PRM: 2 (15 g) | PRM × 10 d | 2 months | ||
| 2 | 38/M | None | TDZ: 1 (2 g) | MTZ × 7d + | Clinical improvement |
| Immigrant | PRM × 10d | No stool test | |||
| Cuba | Lost to follow up | ||||
| 3 | 25/M | None | MTZ: 1 (10.5 g) | MTZ × 10 d + | Clinical improvement |
| Immigrant | PRM × 10 d | Negative stool test | |||
| Nigeria | 1 year | ||||
| 4 | 6/M | None | MTZ: 2 (7.5 g) | TDZ × 3 d + | Clinical improvement |
| Adopted | PRM × 7 d | No stool test | |||
| Colombia | 1 year | ||||
| 5 | 3/M | None | MTZ: 4 (ND) | TDZ × 7 d + | Clinical improvement |
| Adopted | ABZ: 1 (ND) | QNC × 7 d | Negative stool test | ||
| Equatorial Guinea | 2 years | ||||
| 6 | 36/F | Ig A deficiency | MTZ: 1 (10.5 g) | TDZ × 7 d + | Clinical improvement |
| Traveler | ABZ: 1 (8 g) | ABZ × 10 d + | Negative stool test | ||
| Latin American countries | PRM: 1 (7.5 g) | PRM × 10d + | 2 years | ||
| iv IgA | |||||
| 7 | 40/M | None | MTZ: 3 (31.5 g) | MTZ × 10 d + | Clinical improvement |
| Traveler | MBZ: 1 (1 g) | QNC × 10 d | Negative stool test | ||
| Sub-Saharan countries | PRM: 1 (7.5 g) | 6 months | |||
| 8 | 3/M | IgA deficiency | MTZ: 2 (21 g) | TDZ × 1 d + | Clinical improvement |
| Traveler | ABZ × 7 d + | Negative stool test | |||
| Cuba | PRM × 7 d + | 1 month | |||
| iv IgA | |||||
| 9 | 59/M | None | MTZ: 2 (21 g) | TDZ × 7d + | Clinical improvement |
| Spain | MBZ: 1 (1.4 g) | QNC × 7 d | Negative stool test | ||
| 1 year | |||||
| 10 | 60/M | Lung cancer | MTZ: 2 (20 g) | TDZ × 5 d + | Clinical improvement |
| Spain | PRM × 7 d | Negative stool test | |||
| 1 month |
*
Previous anti-giardial drugs, number of full courses (total dose received).
†
Drug doses: MTZ = metronidazole 500 mg every 8 hours (15 mg/kg/d in 3 doses in children); ABZ = albendazole 400 mg every 12 hours; PRM = paromomycin 500–750 mg every 8 hours (30 mg/kg/d in 3 doses in children); TDZ = tinidazole 2 g once (50 mg/kg/d once in children); QNC = quinacrine 100 mg every 8 hours for 7 days (6 mg/kg/d in 3 doses max 300 mg/d in children; iv IgA = intravenous immunoglobulin A.
‡
Three stool samples for ova and parasites after concentration techniques.
M = male; F = female; ND = no data; MBZ = mebendazole.