Table 3.

Chemical structures of treatment options for D. fragilis infections.

Treatment options	Chemical formula	Molecular structure	Side effects/contraindications	Recommended dosagea
Carbarsone	C7H9AsN2O4		Long-term exposure to As has been associated with bladder and kidney cancer; contraindicated for patients with severe hepatic disease	75 mg/kg × 10 days
Diphetarsone	C14H18As2N2O6		Transient hepatic abnormalities, contraindicated for patients with severe hepatic disease	500 mg POb tidc × 10 days
Tetracycline	C22H24N2O8		Detrimental effects on dental development/contraindicated for children under the age of 5 yrs old, renal impaired patients and during pregnancy	500 mg PO qidd × 10 days
				40 mg/kg/day (max. 2 g) PO qid × 10 days
Oxytetracycline	C22H24N2O9		Discolouration of teeth; affects foetal skeletal development/contraindicated for children under 8 yrs old, renal impaired and during pregnancy	General: 250–500 mg PO qid × 10 days
				For severe infections: 250–500 mg PO qid × 7–30 days
Doxycycline	C22H24N2O8		Gastrointestinal disturbances; esophageal ulceration; photosensitising agent/contraindicated for children under the age of 8 yrs old, renal impaired patients and during pregnancy	100–200 mg PO qde × 7–14 days
				1–2 mg/kg/day PO tid
Iodoquinol (hydroxyquinoline)	C5H5I2NO		Nausea; vomiting; abdominal cramps; diarrhoea; skin irritation; fever; chills; headache; dizziness	650 mg PO tid × 7–10 days
				30–40 mg/kg/day PO in three doses × 7–10 days
Clioquinol	C9H5CIINO		Subacute Myelo-Optico-Neuropathy (SMON)	250 mg PO tid × 7 days
				40 mg/kg/day PO × 10 days
Erythromycin	C37H67NO13		GI disturbances; arrhythmia; neurological reactions; contraindicated for women during pregnancy	500 mg PO bidf × 10–14 days
				30–100 mg/kg/day × 10–14 days
Paromomycin	C23H47N5O18S. H2SO4		Diarrhoea; nausea; stomach cramps/seek medical attention for severe allergic reactions	25–35 mg/kg/day PO tid × 7 daysg
Metronidazole	C6H9N3O3		Loss of appetite; metallic taste; headache; insomnia; vertigo; anorexia; vomiting/seek medical attention if experiencing severe adverse effects	500–750 mg PO tid × 10 days
				35–50 mg/kg/day PO tid × 10 days
Secnidazole	C7H11N3O3		GI disturbances; nausea	2 g qd PO
				30 mg/kg qd PO
Ornidazole	C7H10CIN33		GI disturbances; nausea; headache; dizziness	2 g qd PO
				30 mg/kg qd PO
Tinidazole	C8H13N3O4S		GI disturbances; bitter taste; diarrhea; itchiness	2 gg qd PO × 3 days
				50 mg/kg qd × 3 days

^aAdult and paediatric dosages shown where applicable, paediatric dosage is shown below adult dosage.

^bPO = Perorally.

^c“tid” = “ter in die”; “three times a day”.

^d“qid” = “quater in die”; “four times a day”.

^e“qd” = “quaque die”; “once a day”.

^f“bid” = “bis in die”; “twice a day”.

^gUniversal dosage for adults and children.