Nitazoxanide effective in treating enteric protozoal diarrhea
06-Aug-2001
The antimicrobial drug nitazoxanide appears to be
effective in treating diarrhea caused by a variety of
protozoan infections, according to two reports in the
August 1st issue of The Journal of Infectious
Diseases.
In both reports, Dr. Jean-Francois Rossignol from The
Romark Institute for Medical Research, Tampa, Florida,
a part of Romark laboratories, the maker of
nitazoxanide, and colleagues used nitazoxanide to
treat enteric protozoal diarrhea in adults and children
in Egypt.
In their first study, the researchers randomly assigned
50 adults and adolescents, and 50 children, who all
had diarrhea caused by Cryptosporidium parvum, to
nitazoxanide or placebo.
Adults and adolescents received nitazoxanide 500 mg
twice daily for 3 days. Children 1 to 3 years of age
received an oral suspension (100 mg/5 mL) of 5 mL
nitazoxanide and children 4 to 11 years of age
received 10 mL nitazoxanide twice daily for 3 days,
the researchers report.
For the 99 patients who completed the trial, 39 of the
49 patients who received nitazoxanide had resolution
of diarrhea after day 7 of treatment compared with 20
of 49 patients who received placebo (p < 0.0001). In
addition, 33 of the patients in the nitazoxanide group
had no oocysts in posttreatment stool samples
compared with 11 of 50 patients in the placebo group
(p < 0.001).
Among patients in the nitazoxanide group, there was
a median of 3 days from the start of treatment to
passage of the last unformed stool. The comparable
median time for patients in the placebo group could
not be calculated, the investigators note, because
59% of these patients still had diarrhea at the end of
the follow-up period.
In the second study, Dr. Rossignol's group randomized
89 adults and adolescents with diarrhea caused by
Giardia intestinalis, Entamoeba histolytica or E. dispar
to 500 mg nitazoxanide twice daily for 3 days or
placebo.
Results of this study were similar to those found in
the preceding trial; 38 of 47 of patients who received
nitazoxanide had resolution of their diarrhea within 7
to 10 days after starting treatment, compared with 17
of 42 patients in the placebo group (p < 0.0002).
As in the first trial, the researchers observed a median
of 3 days from the start of nitazoxanide to the last
unformed stool, while 60% of the placebo patients
continued to have diarrhea at the end of the follow-up
period.
Given these results, Dr. Rossignol and colleagues
believe that "nitazoxanide could play an important
role in the management of diarrhea caused by enteric
protozoa, reducing morbidity and costs associated
with these diarrheal illnesses."
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