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Query: UMLS:C0017536 (giardiasis)
 1,714 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Therapeutic effects of metronidazole (Flagyl), tinidazole (Tricolam 500) and chlorhydrate of quinacrine in a study of 106 children with symptomatic giardiasis are compared. To evaluate results, cure percentage, efficacy and presence of secondary effects were quantified. Tinidazole was demonstrated most effective drug (96% effective) when compared with quinacrine (83.3% effective) and metronidazole (70.2%) (p less than 0.05). Authors recommend following regime: tinidazole 50-75 mg/kg divided in 2-3 doses, one day; chlorhydrate of quinacrine 6 mg/kg/day divided in 3 doses, five days; metronidazole 15-20 mg/kg/day divided in 3 doses, seven to ten days.
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PMID:[Therapeutic results in Giardia lamblia infestation]. 317 58

Metronidazole, a nitroimidazole derivative, is a unique antimicrobial agent that is active against both bacterial and parasitic organisms, although only the anaerobic members of these groups are susceptible. It has been used for the treatment of trichomoniasis for almost 30 years and is also effective in amebiasis and giardiasis. More recently, metronidazole has emerged as a principal agent for the treatment of anaerobic infections. It is highly effective against all species of anaerobes except certain non-spore-forming gram-positive bacilli and cocci and is the only agent rapidly bactericidal against the Bacteroides fragilis group. The hydroxy metabolite is 65% as effective as metronidazole and may play a major therapeutic role. Clinical studies have substantiated its efficacy for prophylaxis during elective colorectal surgical procedures and the treatment of deep abdominal sepsis (usually in combination with another agent such as an aminoglycoside). Metronidazole is the treatment of choice for bacterial vaginosis and seems to be as effective as vancomycin for treatment of Clostridium difficile-related diarrhea and colitis. Good blood levels are produced after both oral and intravenous administration, and side effects are infrequent and minimal. Metronidazole should not be taken during the first trimester of pregnancy because of concerns about mutagenicity. Tinidazole and ornidazole are recently developed nitroimidazole derivatives that have even greater antimicrobial activity than metronidazole.
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PMID:Symposium on antimicrobial agents. Metronidazole. 331 51

A simple rapid method for the measurement of adherence of Giardia lamblia trophozoites is described. Microcolumns are prepared from 10 mg amounts of nylon fibre packed into 100 microliter size disposable pipette tips. The kinetics show that 30 min is the optimum contact time for the experiments. Maximum adherence occurred at 37 degrees C, minimal at 4 degrees C, and intermediate at 25 degrees C, suggesting that adherence is an energy-dependent process. Adherence was fluoride-sensitive but cyanide-insensitive, suggesting that this parasite derives its energy from the glycolytic pathway, and not the oxidative pathway. Metronidazole, one of the mainstays for chemotherapy of giardiasis, produced significant inhibition of adherence at 10 micrograms/ml and 100 micrograms/ml concentrations after one hour pre-incubation.
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PMID:The adherence of Giardia lamblia trophozoites to nylon fibre microcolumns: effect of temperature, fluoride, cyanide and metronidazole. 403 37

The role drug resistance plays in the occurrence of chronic and recurrent giardiasis has not been established. Extensive data on the susceptibility to antimicrobial agents of living Giardia spp. trophozoites from human origin are lacking. We have determined with a macrodilution method in semisolid medium the in vitro susceptibility of 25 Giardia lamblia isolates, all obtained by routine cultivation of the duodenal fluid of children to six commonly used antiprotozoal drugs. The results showed tinidazole to be the most active drug (all isolates have MICs of less than or equal to 0.5 micrograms/ml). Metronidazole was equally active on all but one isolate, for which an MIC between 0.5 and 1 micrograms/ml was found. Furazolidone was the most active nonimidazole compound tested. More than 50% of the isolates were very susceptible to paromomycin, pyrimethamine, and chloroquine. Two of the strains presented an MIC for paromomycin higher than 10 micrograms/ml, and six strains needed more than 50 micrograms of pyrimethamine per ml to be inhibited. Decreased susceptibility of several of the isolates to different agents appears to be linked.
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PMID:In vitro susceptibilities of 25 Giardia lamblia isolates of human origin to six commonly used antiprotozoal agents. 407 61

Metronidazole, a nitroimidazole derivative, is a unique antimicrobial agent that is active against both bacterial and parasitic organisms, although only the anaerobic members of these groups are susceptible. It has been used for the treatment of trichomoniasis for about 20 years and is also effective against amebiasis and giardiasis. More recently, metronidazole has emerged as a principal agent for the treatment of anaerobic bacterial infections. It is highly effective against all species of anaerobes except certain non-spore-forming gram-positive bacilli and cocci and is the only agent rapidly bactericidal against the Bacteroides fragilis group. Clinical studies have proved its efficacy in prophylaxis for elective colorectal surgical procedures and in the treatment of deep abdominal sepsis (usually in combination with another agent, such as an aminoglycoside). Metronidazole is the treatment of choice for nonspecific vaginitis that seems to be a mixed infection due to anaerobes and Gardnerella vaginalis. Adequate concentrations in the blood are produced after both oral and intravenous administration, and the side effects are infrequent and minimal.
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PMID:Metronidazole. 660 Aug 4

Certain enteric ailments are particularly common among homosexual men. They are primarily infectious diseases and include not only such common venereal diseases as gonorrhea and syphilis but also infections not usually regarded as being sexually transmitted. Among the latter are shigellosis, salmonellosis, giardiasis, and amebiasis. Patients' symptoms are non-specific and seldom helpful in diagnosing particular diseases. The practitioner must be prepared to identify a number of infections with similar presentations that may occur singly or together in gay men. Gonorrhea is probably the most common bacterial infection in gay men. Carriage rates as high as 50% have been reported, and extra-genital carriage is common; this necessitates culturing the urethra, rectum, and pharynx. Procaine penicillin G is the treatment of choice for most patients; spectinomycin is probably the drug of choice in penicillin-sensitive patients. In contrast to other venereal diseases, syphilis may have a characteristic protoscopic presentation. Benzathine penicillin G is the treatment of choice for most patients. Lymphogranuloma venereum causes penile lesions and inguinal lymphadenitis in heterosexual men, whereas homosexual men are more prone to proctitis. The disease may mimic Crohn's disease. Recommended treatment includes tetracycline or sulfamethoxazole-trimethoprim. Shigellosis usually presents as an acute diarrheal illness. Patients generally require only supportive treatment with fluids. Herpes simplex viral infection is difficult to diagnose and has several different presentations, including lumbosacral radiculomyelopathy. Symptomatic treatment with sitz baths, anesthetic ointment, and analgesics is recommended. Venereal warts are believed to be caused by the same virus that causes verrucous warts; they are usually found in the anal canal or around the anal orifice. They are commonly treated with 25% podophyllin solution. Parasitic infections include giardiasis, amebiasis, and pinworm infections. Metronidazole may be used in the treatment of symptomatic giardiasis and amebiasis, but it is not approved for the former indication; quinacrine is approved for giardiasis. Pinworm infestation may be treated with pyrantel pamoate or mebendazole. Cure of enteric diseases in homosexual men must be documented.
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PMID:Enteric diseases of homosexual men. 676 90

Metronidazole is a 5-nitroimidazole that has selective activity against anaerobic microorganisms, including bacteria and protozoa. Intravenous metronidazole has recently been approved by the U.S. Food and Drug Administration for the treatment of serious anaerobic bacterial infections. It is usually bactericidal at low concentrations, and its spectrum of activity encompasses almost all anaerobic bacteria and some capnophilic organisms. Anaerobic bacteria known to be resistant to metronidazole include occasional anaerobic cocci, some nonsporulating gram-positive bacilli and propionibacterium. Metronidazole is the most active antimicrobial agent against Bacteroides fragilis, the most resistant of anaerobic bacteria. Kill-curve studies demonstrate that there is a 2 to 5 log decrease in the number of colony forming units of B. fragilis and Clostridium perfringens within one hour. The only well documented metronidazole-resistant strain is a B. fragilis isolated from the normal flora of a patient on long-term metronidazole therapy for Crohn's Disease. Metronidazole resistance in Trichomonas vaginalis has recently been described in a few strains that are able to survive at increased oxygen tensions. Metronidazole has been shown to be efficacious in certain protozoal infections including trichomonal vaginitis, extraintestinal amebiasis, and giardiasis. Clinical studies have shown metronidazole to be efficacious in the therapy of a variety of anaerobic infections, including non-traumatic brain abscesses, intraabdominal sepsis, pelvic suppuration and necrotizing soft tissue infections. There have been disappointing results in the therapy of anaerobic pleuropulmonary infections with a number of superinfections caused by aerobic bacteria. Since metronidazole lacks any activity against aerobic bacteria, it must be combined with other agents, usually aminoglycosides, in the treatment of mixed infections involving anaerobic and aerobic bacteria.
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PMID:Metronidazole: in vitro activity, pharmacology and efficacy in anaerobic bacterial infections. 692 1

Giardia lamblia has emerged as the most common intestinal parasite in the United States. This article presents a brief review of the clinically important aspects of giardiasis and evaluates the currently used therapeutic agents. Three drugs have been advocated for the treatment of giardiasis; furazolidone (Furoxone), metronidazole (Flagyl), and quinacrine (Atabrine). None of them, however, is ideal. Metronidazole and quinacrine are more effective than furazolidone, but furazolidone has the advantage of a liquid formulation that makes administration to children easier. Quinacrine is much less expensive than the other two agents but has a somewhat higher rate of side effects and a bitter taste. There is concern about the carcinogenic potential of furazolidone and metronidazole, but this has not been evaluated for quinacrine. In the balance, we conclude that quinacrine is probably the preferable drug to use in the pediatric age group because of proven effectiveness and lower cost.
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PMID:Treatment of giardiasis: literature review and recommendations. 704 42

The prevalence of giardiasis was studied in 77 parakeets from 4 widely varied sources and was found to be 66%. The infection appeared most common in young birds. Cysts and trophozoites were found in fecal samples and persisted in birds caged alone for up to 4 months, New infections appeared when infected and noninfected birds were caged together, Treatment with 200 ppm of dimetridazole in the drinking water was less effective than 3 oral doses given at the rate of 1.5 mg/30 g of body weight every 12 hours by stomach tube. Metronidazole therapy was not effective.
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PMID:The nature and treatment of giardiasis in parakeets. 706 16

One hundred fifty-nine children aged 24 to 61 months with 60% ascariasis prevalence and 21.5% giardiasis prevalence in rural Guatemala were studied prospectively for 1 yr. They were divided into four groups comparable for age, sex, socioeconomic status, and past growth experience as judged by slopes of height and weight on age. Each group was randomly assigned to the following 2-monthly treatment regimens: group I, placebo, group II, piperazine, group III, metronidazole; group IV, piperazine and metronidazole. Height and weight were measured every 3 months and stools were examined for parasites every 4 months. Piperazine administration decreased the prevalence of ascariasis to 33.8% at the end of the study but growth remained unaltered. Metronidazole administration decreased the prevalence of giardiasis to 2.5% at the end of the study and was accompanied by increased growth as judged by delta weight, delta % weight for age, slope of weight on age, delta height, delta % height for age and slope of height on age. It is suggested that failure of antiascaris treatment to enhance growth in this study may be because of 1) absence of severe malnutrition in the subjects, 2) adequacy of dietary protein, 3) possible low worm load, and 4) failure to eradicate ascariasis. The findings suggest that giardiasis is associated with reduced growth in preschool children.
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PMID:Effect of periodic antiascaris and antigiardia treatment on nutritional status of preschool children. 709 Oct 37


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