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

Yıl 2010, Cilt: 67 Sayı: 3, 113 - 119, 01.09.2010

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

Kaynakça

  • Ringqvist E, Palm JE, Skarin H, Hehl AB, Weiland M, Davids BJ, et al. Release of metabolic enzymes by Giardia in response to interaction with intestinal epithelial cells. Mol Biochem Parasitol, 2008; 159 (2): 85-91.
  • Upcroft P, Upcroft J. Drugs target and mechanisms of resistance in the anaerobic protozoa. Clin Microbiol Rev, 2001; 14: 150-64.
  • Sterk M, Müller J, Hemphill A, Müller N. Characterization of a Giardia lamblia WB C6 clone resistant to the isoflavone formononetin. Microbiol, 2007; 153 (Pt 12): 4150-8.
  • Müller J, Ley S, Felger I, Hemphill A , Müller N. Identification of differentially expressed genes in a Giardia lamblia WB C6 clone resistant to nitazoxanide and metronidazole. J Antimicrob Chemother, 2008; 62(1): 72-82.
  • Aslam S, Musher DM. Nitazoxanide: clinical studies of a broad-spectrum anti-infective agent. Future Microbiol, 2007; 2: 583-90.
  • Cedillo-Rivera R, Chávez B, González-Robles A, Tapia A, Yépez- Mulia L. In vitro effect of nitazoxanide against Entamoeba histolytica, Giardia intestinalis, and Trichomonas vaginalis trophozoites. J Eukaryot Microbiol, 2002; 49(3): 201-8.
  • Ortiz JJ, Ayoub A, Gargala G Chegne NL, Favennec L. Randomized clinical study of nitazoxanide compared to metronidazole in the treatment of symptomatic giardiasis in children from Northern Peru. Aliment Pharmacol Ther, 2001; 15(9): 1409-15.
  • Rossignol JF, Ayoub A, Ayers MS. Treatment of diarrhea caused by Giardia intestinalis and Entamoeba histolytica or E. dispar: a randomized, double-blind, placebo-controlled study of nitazoxanide. J Infect Dis, 2001; 184(3): 381-4.
  • García LS, Bruckner DA. Macroscopic and microscopic examination of faecal specimens. In: Diagnostic medical parasitology. Washington, DC: American Society for Microbiology, 1993, pp. 501-40.
  • Armitage P, Berry G. Statistical methods in medical research, 2nd ed. Oxford: Blackwell Scientific, 1987. Thielman NM, Guerrant R. Acute infectious diarrhea. N Engl J Med, 2004; 350: 38-47.
  • Herikstad H, Yang S, Van Gilder TJ, Vugia D, Hadler J, Blake P, et al. A population-based estimate of the burden of diarrhoeal illness in the United States: FootNet, 1996-7. Epidemiol Infect, 2002; 129: 9-17.
  • Wistrom J, Jertborn M, Ekwall E. Empiric treatment of acute diarrheal disease with norfloxacin: a randomized, placebo-controlled trial. Ann Intern Med, 1992; 117: 202-8.
  • Escobedo AA, Cimerman S. Giardiasis: A pharmacotherapy review. Expert Opinion on Pharmacotherapy, 2007; 8:1885-902.
  • Rossignol JF, Kabil SM, El-Gohary Y, Elfert A, Keeffe EB. Clinical trial: randomized, double-blind, placebocontrolled study of nitazoxanide monotherapy for the treatment of patients with chronic hepatitis C genotype 4. Aliment Pharmacol Ther, 2008; 28(5): 574-80.
  • Rossignol JF, El-Gohary YM. Nitazoxanide in the treatment of viral gastroenteritis: a randomized double-blind placebo-controlled clinical trial. Aliment Pharmacol Ther, 2006; 24(10): 1423-30.
  • Musher DM, Logan N, Hamill RJ, Dupont HL, Lentnek A, Gupta A, et al. Nitazoxanide for the treatment of Clostridium difficile colitis. Clin Infect Dis, 2006; 43(4): 421-7.
  • Rodríguez-García R, Rodríguez-Guzmán LM, Cruz del Castillo AH. Effectiveness and safety of mebendazole compared to nitazoxanide in the treatment of Giardia lamblia in children. Rev Gastroenterol Mex, 1999; 64(3): 122-6.
  • Abaza H, El-Zayadi A, Kabil SM. Nitazoxanide in the treatment of patients with intestinal protozoan and helminthic infections: a report on 546 patients in Egypt. Curr Ther Res, 1998; 59, 116-21.
  • Abboud P, Lemée V, Gargala G, Brasseur P, Ballet JJ, BorsaLebas F et al. Successful treatment of metronidazoleand albendazole-resistant giardiasis with nitazoxanide in a patient with acquired immunodeficiency syndrome. Clin Infect Dis, 2001; 32(12): 1792-4.
  • Escobedo AA, Alvarez G, González ME, Almirall P, Cañete R, Cimerman S, et al. The treatment of giardiasis in children: single-dose tinidazole compared with 3 days of nitazoxanide. Ann Trop Med Parasitol, 2008; 102(3): 199-207.
  • Di Prisco MC, Jiménez JC, Rodríguez N, Costa V, Villamizar J, Silvera A, et al. Clinical trial with secnidazole in a single dose in Venezuelan children infected by Giardia intestinalis. Invest Clin, 2000; 41(3): 179-88.
  • Cimerman B, Camilo Coura L, C Salle JM, Gurvitz R, Rocha RS, Bandeira S, et al. Evaluation of secnidazole gel and tinidazole suspension in the treatment of giardiasis in children. Braz J Infect Dis, 1997; 1(5): 241-7.
  • Favennec L, Jave Ortiz J, Gargala G, Lopez Chegne N, Ayoub A, Rossignol JF. Double-blind, randomized, placebo-controlled study of nitazoxanide in the treatment of fascioliasis in adults and children from Northern Peru. Aliment Pharmacol Ther, 2003; 17(2): 265-70.

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

Yıl 2010, Cilt: 67 Sayı: 3, 113 - 119, 01.09.2010

Öz

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

Kaynakça

  • Ringqvist E, Palm JE, Skarin H, Hehl AB, Weiland M, Davids BJ, et al. Release of metabolic enzymes by Giardia in response to interaction with intestinal epithelial cells. Mol Biochem Parasitol, 2008; 159 (2): 85-91.
  • Upcroft P, Upcroft J. Drugs target and mechanisms of resistance in the anaerobic protozoa. Clin Microbiol Rev, 2001; 14: 150-64.
  • Sterk M, Müller J, Hemphill A, Müller N. Characterization of a Giardia lamblia WB C6 clone resistant to the isoflavone formononetin. Microbiol, 2007; 153 (Pt 12): 4150-8.
  • Müller J, Ley S, Felger I, Hemphill A , Müller N. Identification of differentially expressed genes in a Giardia lamblia WB C6 clone resistant to nitazoxanide and metronidazole. J Antimicrob Chemother, 2008; 62(1): 72-82.
  • Aslam S, Musher DM. Nitazoxanide: clinical studies of a broad-spectrum anti-infective agent. Future Microbiol, 2007; 2: 583-90.
  • Cedillo-Rivera R, Chávez B, González-Robles A, Tapia A, Yépez- Mulia L. In vitro effect of nitazoxanide against Entamoeba histolytica, Giardia intestinalis, and Trichomonas vaginalis trophozoites. J Eukaryot Microbiol, 2002; 49(3): 201-8.
  • Ortiz JJ, Ayoub A, Gargala G Chegne NL, Favennec L. Randomized clinical study of nitazoxanide compared to metronidazole in the treatment of symptomatic giardiasis in children from Northern Peru. Aliment Pharmacol Ther, 2001; 15(9): 1409-15.
  • Rossignol JF, Ayoub A, Ayers MS. Treatment of diarrhea caused by Giardia intestinalis and Entamoeba histolytica or E. dispar: a randomized, double-blind, placebo-controlled study of nitazoxanide. J Infect Dis, 2001; 184(3): 381-4.
  • García LS, Bruckner DA. Macroscopic and microscopic examination of faecal specimens. In: Diagnostic medical parasitology. Washington, DC: American Society for Microbiology, 1993, pp. 501-40.
  • Armitage P, Berry G. Statistical methods in medical research, 2nd ed. Oxford: Blackwell Scientific, 1987. Thielman NM, Guerrant R. Acute infectious diarrhea. N Engl J Med, 2004; 350: 38-47.
  • Herikstad H, Yang S, Van Gilder TJ, Vugia D, Hadler J, Blake P, et al. A population-based estimate of the burden of diarrhoeal illness in the United States: FootNet, 1996-7. Epidemiol Infect, 2002; 129: 9-17.
  • Wistrom J, Jertborn M, Ekwall E. Empiric treatment of acute diarrheal disease with norfloxacin: a randomized, placebo-controlled trial. Ann Intern Med, 1992; 117: 202-8.
  • Escobedo AA, Cimerman S. Giardiasis: A pharmacotherapy review. Expert Opinion on Pharmacotherapy, 2007; 8:1885-902.
  • Rossignol JF, Kabil SM, El-Gohary Y, Elfert A, Keeffe EB. Clinical trial: randomized, double-blind, placebocontrolled study of nitazoxanide monotherapy for the treatment of patients with chronic hepatitis C genotype 4. Aliment Pharmacol Ther, 2008; 28(5): 574-80.
  • Rossignol JF, El-Gohary YM. Nitazoxanide in the treatment of viral gastroenteritis: a randomized double-blind placebo-controlled clinical trial. Aliment Pharmacol Ther, 2006; 24(10): 1423-30.
  • Musher DM, Logan N, Hamill RJ, Dupont HL, Lentnek A, Gupta A, et al. Nitazoxanide for the treatment of Clostridium difficile colitis. Clin Infect Dis, 2006; 43(4): 421-7.
  • Rodríguez-García R, Rodríguez-Guzmán LM, Cruz del Castillo AH. Effectiveness and safety of mebendazole compared to nitazoxanide in the treatment of Giardia lamblia in children. Rev Gastroenterol Mex, 1999; 64(3): 122-6.
  • Abaza H, El-Zayadi A, Kabil SM. Nitazoxanide in the treatment of patients with intestinal protozoan and helminthic infections: a report on 546 patients in Egypt. Curr Ther Res, 1998; 59, 116-21.
  • Abboud P, Lemée V, Gargala G, Brasseur P, Ballet JJ, BorsaLebas F et al. Successful treatment of metronidazoleand albendazole-resistant giardiasis with nitazoxanide in a patient with acquired immunodeficiency syndrome. Clin Infect Dis, 2001; 32(12): 1792-4.
  • Escobedo AA, Alvarez G, González ME, Almirall P, Cañete R, Cimerman S, et al. The treatment of giardiasis in children: single-dose tinidazole compared with 3 days of nitazoxanide. Ann Trop Med Parasitol, 2008; 102(3): 199-207.
  • Di Prisco MC, Jiménez JC, Rodríguez N, Costa V, Villamizar J, Silvera A, et al. Clinical trial with secnidazole in a single dose in Venezuelan children infected by Giardia intestinalis. Invest Clin, 2000; 41(3): 179-88.
  • Cimerman B, Camilo Coura L, C Salle JM, Gurvitz R, Rocha RS, Bandeira S, et al. Evaluation of secnidazole gel and tinidazole suspension in the treatment of giardiasis in children. Braz J Infect Dis, 1997; 1(5): 241-7.
  • Favennec L, Jave Ortiz J, Gargala G, Lopez Chegne N, Ayoub A, Rossignol JF. Double-blind, randomized, placebo-controlled study of nitazoxanide in the treatment of fascioliasis in adults and children from Northern Peru. Aliment Pharmacol Ther, 2003; 17(2): 265-70.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Araştırma Makalesi
Yazarlar

Maria Elena González Bu kişi benim

Roberto Cañete Villafranca Bu kişi benim

Giselle álvarez Bu kişi benim

Katia Brito Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2010
Yayımlandığı Sayı Yıl 2010 Cilt: 67 Sayı: 3

Kaynak Göster

APA González, M. E., Villafranca, R. C., álvarez, G., Brito, K. (2010). Nitazoxanide for the treatment of Giardia duodenalis infection: a comparative trial with secnidazole. Türk Hijyen Ve Deneysel Biyoloji Dergisi, 67(3), 113-119.
AMA González ME, Villafranca RC, álvarez G, Brito K. Nitazoxanide for the treatment of Giardia duodenalis infection: a comparative trial with secnidazole. Turk Hij Den Biyol Derg. Eylül 2010;67(3):113-119.
Chicago González, Maria Elena, Roberto Cañete Villafranca, Giselle álvarez, ve Katia Brito. “Nitazoxanide for the Treatment of Giardia Duodenalis Infection: a Comparative Trial With Secnidazole”. Türk Hijyen Ve Deneysel Biyoloji Dergisi 67, sy. 3 (Eylül 2010): 113-19.
EndNote González ME, Villafranca RC, álvarez G, Brito K (01 Eylül 2010) Nitazoxanide for the treatment of Giardia duodenalis infection: a comparative trial with secnidazole. Türk Hijyen ve Deneysel Biyoloji Dergisi 67 3 113–119.
IEEE M. E. González, R. C. Villafranca, G. álvarez, ve K. Brito, “Nitazoxanide for the treatment of Giardia duodenalis infection: a comparative trial with secnidazole”., Turk Hij Den Biyol Derg, c. 67, sy. 3, ss. 113–119, 2010.
ISNAD González, Maria Elena vd. “Nitazoxanide for the Treatment of Giardia Duodenalis Infection: a Comparative Trial With Secnidazole”. Türk Hijyen ve Deneysel Biyoloji Dergisi 67/3 (Eylül 2010), 113-119.
JAMA González ME, Villafranca RC, álvarez G, Brito K. Nitazoxanide for the treatment of Giardia duodenalis infection: a comparative trial with secnidazole. Turk Hij Den Biyol Derg. 2010;67:113–119.
MLA González, Maria Elena vd. “Nitazoxanide for the Treatment of Giardia Duodenalis Infection: a Comparative Trial With Secnidazole”. Türk Hijyen Ve Deneysel Biyoloji Dergisi, c. 67, sy. 3, 2010, ss. 113-9.
Vancouver González ME, Villafranca RC, álvarez G, Brito K. Nitazoxanide for the treatment of Giardia duodenalis infection: a comparative trial with secnidazole. Turk Hij Den Biyol Derg. 2010;67(3):113-9.