Giardia duodenalis enfeksiyonlarının tedavisinde Nitazoksanid: seknidazol ile karşılaştırmalı bir tedavi.

Öz

Amaç: Nitazoksanid NTZ , çeşitli intestinal protozoalar, helmintler ve anaerob bakterilere karşı etki gösteren geniş spekturumlu, Amerika Birleşik Devletleri’nde Cryptosporidium spp. ve Giardia duodenalis tedavisi için ruhsatlandırılmış 5-nitrotiazol türevi bir ilaçtır. Bu çalışmada, Giardiazis tedavisinde nitazoksanid kullanımının güvenilirlik ve etkinlik yönünden seknidazol SNZ ile karşılaştırılması amaçlanmıştır.Yöntem: Randomize kontrollü açık-etiketli bu çalışma Küba Enstitüsü Gastroenteroloji Kliniğinde, sadece Giardia duodenalis enfeksiyonu olan yetişkin hastalarda yürütülmüştür. 125 hasta rastgele olarak NTZ [3 gün, günde 2 kez 500 mg n= 62 ] ya da SNZ [ 2 g / Tek doz n= 63 ] tedavisi uygulanmak üzere belirlenmiştir. Etkinlik değerlendirmesi parazitolojik cevaba göre yapılmıştır. Tedavinin tamamlanmasından sonraki 3., 5. ve 10. günlerde tüm hastalardan fekal örnek verilmesi istenmiştir. Tedavi sonrası alınan her üç dışkı örneğinin hiçbirinde Nativ-Lugol ve/veya Ritchie konsantrasyonu teknikleriyle Giardia trofozoitleri veya kistleri tespit edilemeyen hastalar tedavi edilmiş olarak değerlendirilmiştir. Bulgular: Tedavi oranı NTZ [%95.2 - 59/62 ] uygulanan grupta SNZ [%93.7 - 59/63 ] uygulanan gruba göre biraz daha yüksek olmakla beraber istatistiksel olarak anlamlı bulunmamıştır P>0.05 . Acı tat alma sadece SNZ uygulanan grupta sarımsı renkte idrar çıkarma ile beraber görülürken döküntü oluşumu sadece NTZ tedavisi verilen grupta görülmüştür. Bulantı ve başağrısına SNZ tedavisi verilen grupta daha sık rastlanmıştır P

Anahtar Kelimeler

• Giardia duodenalis enfeksiyonu, Giardia duodenalis tedavisi, seknidazol, nitazoksanid, Küba

Nitazoxanide for the treatment of Giardia duodenalis infection: a comparative trial with secnidazole.

Abstract

Objective: Nitazoxanide is a 5-nitrothiazolyl derivative with broad-spectrum activity against numerous intestinal protozoa, helminths and anaerobic bacteria licensed in the United States for the treatment of Cryptosporidium spp. and Giardia duodenalis. The aim of this study was to compare the efficacy and safety of nitazoxanide NTZ versus secnidazole SNZ in the treatment of giardiasis. Method: A randomized controlled open-label trial was carried out at the Cuban Institute of Gastroenterology in adults with confirmed Giardia duodenalis mono-infection. 125 patients were randomly assigned to receive either NTZ [500 mg two times daily for three days n= 62 ] or SNZ [2 g single dose n= 63 ]. The evaluation of the efficacy was based on parasitological response. All patients were asked to provide three faecal samples on days 3, 5, and 10 after treatment completion. Patients were considered to be cured, if no Giardia trophozoites or cysts were found in any of the three post-treatment faecal specimens evaluated by direct wet mounts and/or after Ritchie concentration techniques. Results: The frequency of cure was a little higher for NTZ [95.2%- 59/62 ] than for SNZ [93.7%- 59/63 ] but the difference was not statistically significant P>0.05 . Bitter taste was only reported in SNZ treated group were as yellowish coloration of the urine and rash were only reported in NTZ treated group. Nausea and headache were more common in patients treated with SNZ P

Keywords

• Giardia duodenalis infection, drug therapy, secnidazole, nitazoxanide, Cuba

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