Randomized clinical study of nitazoxanide compared to metronidazole in the treatment of symptomatic giardiasis in children from Northern Peru

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Abstract
Background: Enteric infection by Giardia intestinalis is a common cause of diarrhoea world‐wide and a significant cause of morbidity in children.Aim: To compare the efficacy and safety of nitazoxanide and metronidazole in the treatment of diarrhoea caused by G. intestinalis in children.Methods: A total of 110 children presenting with diarrhoea caused by G. intestinalis were randomized to treatment with either a 3‐day course of nitazoxanide (100 mg b.d., age range 2–3 years; 200 mg b.d., age range 4–11 years) or a 5‐day course of metronidazole (125 mg b.d., age range 2–5 years; 250 mg b.d., age range 6–11 years). The patients were followed‐up for a determination of clinical response 7 days after the initiation of treatment, and two subsequent stool samples were collected for parasitological examination.Results: Diarrhoea had resolved in 47 children out of 55 (85%) in the nitazoxanide treatment group before the day 7 follow‐up visit, compared to 44 out of 55 (80%) for metronidazole. Diarrhoea resolved within 4 days in most cases. Only mild, transient adverse events were reported.Conclusions: A 3‐day course of nitazoxanide suspension is as efficacious as a standard 5‐day course of metronidazole suspension in treating giardiasis in children.

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