2004, Number 4
<< Back Next >>
salud publica mex 2004; 46 (4)
Nitazoxanide vs albendazole against intestinal parasites in a single dose and for three days
Belkind-Valdovinos U, Belkind-Gerson J, Sánchez-Francia D, Espinoza-Ruiz MM, Lazcano-Ponce E
Language: Spanish
References: 30
Page: 333-340
PDF size: 228.86 Kb.
ABSTRACT
Objective. To assess the efectiveness of the usual dose of nitazoxanide administered for three days and as a single dose for massive eradication of intestinal parasites in the pediatric population, compared with single-dose albendazole.
Material and Methods. A randomized clinical trial was conducted in three rural communities in central Mexico City between 2001 and 2003 to assess three possible therapy regimes in a study population of 786 children 5 to 11 years of age, 92 of whom had a positive parasitology test result (15.1%). Group 1 included 27 patients treated with 400 mg given as a single dose of albendazole; group 2 included 34 patients whose therapy consisted of a 15 mg/kg/day dose for three consecutive days; patients in group 3 (n=31) were administered a single 1.2 g dose of nitazoxanide. Differences in proportions were assessed using Fisher’s exact test.
Results. No statistically significant differences were found in the effectiveness of the three treatment regimes: 80.5% with albendazole, compared with the two nitazoxanide alternatives (67.6% and 71%, respectively. A higher prevalence of side effects was observed with nitazoxanide in the threeday regimen (26.5%) and as a single dose (32.2%), compared with a single dose of albendazole (7.4%).
Conclusions. According to the evidence on effectiveness and side effects, the use of nitazoxanide is not justified as a massive prophylactic medication for intestinal parasitosis control alternative in endemic areas. In countries with a high prevalence of intestinal parasitosis primary prevention measures should be the most important strategy, together with public sanitation, drinking water and sewage system availability, water chlorination, and appropriate animal fecal waste disposal, as well as health education.
REFERENCES
Nahmias J, Greenberg Z, Djerrasi L, Giladi L. Mass treatment of intestinal parasites among Ethiopian immigrants. Isr J Med Sci 1991;27(5):278-283.
World Health Organization. Prevention and control of intestinal parasitic infections. Report of a WHO Expert Committee. Ginebra: WHO; 1987 (WHO Technical Report Series No. 749. 6).
Morales-Espinoza EM, Sánchez-Pérez HJ, García-Gil M del M, Vargas-Morales G, Méndez-Sánchez JD, Pérez-Ramírez M. Intestinal parasites in children, in highly deprived areas in the border region of Chiapas, Mexico. Salud Publica Mex 2003;45(5):379-388.
Geltman P, Meyers A. Treatment of intestinal parasites in immigrants. N Engl J Med 1999 29;341(5):377-378.
Legesse M, Erko B, Medhin G. Efficacy of alebendazole and mebendazole in the treatment of Ascaris and Trichuris infections. Ethiop Med J 2002;40(4):335-343.
Albonico M, Bickle Q, Ramsan M, Montresor A, Savioli L, Taylor M. Efficacy of mebendazole and levamisole alone or in combination against intestinal nematode infections after repeated targeted mebendazole treatment in Zanzibar. Bull World Health Organ 2003;81(5):343-352.
Navarrete-Vázquez G, Yépez L, Hernández-Campos A, Tapia A, Hernández-Luis F, Cedillo R et al. Synthesis and antiparasitic activity of albendazole and mebendazole analogues. Bioorg Med Chem 2003 15;11(21):4615-4622.
Dotsenko VA, Ordyntseva AP, Makarova TA, Shirinian AA, Lysakova LA. Experience with the use of nemocide (pyrantel pamoate) in nematodiases. Med Parazitol. 1989;27(5):36-39.
Albonico M, Smith PG, Hall A, Chwaya HM, Alawi KS, Savioli L. A randomized controlled trial comparing mebendazole and albendazole against Ascaris, Trichuris and hookworm infections. Trans R Soc Trop Med Hyg 1994;88(5):585-589.
Horton J. Albendazole: A review of anthelmintic efficacy and safety in humans. Parasitology 2000; 121 Suppl:S113-S1132.
Mascie-Taylor CG, Alam M, Montanari RM, Karim R, Ahmed T, Karim E et al. A study of the cost effectiveness of selective health interventions for the control of intestinal parasites in rural Bangladesh. J Parasitol 1999; 85(1):6-11.
Wright JM, Dunn LA, Upcroft P, Upcroft JA. Efficacy of antigiardial drugs. Expert Opin Drug Saf 2003 Nov;2(6):529-541.
Petri WA. Therapy of intestinal protozoa. Trends Parasitol 2003;19(11):523-526.
White AC Jr. Nitazoxanide: An important advance in anti-parasitic therapy. Am J Trop Med Hyg 2003 Apr;68(4):382-383.
Fonseca-Salamanca F, Martínez-Grueiro MM, Martínez-Fernández AR. Nematocidal activity of nitazoxanide in laboratory models. Parasitol Res 2003;91(4):321-324.
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):201-208.
Amadi B, Mwiya M, Musuku J, Watuka A, Sianongo S, Ayoub A et al. Effect of nitazoxanide on morbidity and mortality in Zambian children with cryptosporidiosis: A randomised controlled trial. Lancet 2002;360(9343):1375-1380.
Adagu IS, Nolder D, Warhurst DC, Rossignol JF. In vitro activity of nitazoxanide and related compounds against isolates of Giardia intestinalis, Entamoeba histolytica and Trichomonas vaginalis. J Antimicrob Chemother 2002;49(1):103-111.
Rossignol JF, Maisonneuve H. Nitazoxanide in the treatment of Taenia saginata and Hymenolepis nana infections. Am J Trop Med Hyg 1984; 33(3):511-512.
Larrosa-Haro A, Ruiz-Pérez M, Aguilar-Benavides S. Utility of studying feces for the diagnosis and management of infants and preschool children with acute diarrhea. Salud Publica Mex 2002;44(4):328-334.
Gilles HM, Hoffman PS. Treatment of intestinal parasitic infections: A review of nitazoxanide. Trends Parasitol 2002;18(3):95-97.
Dunne RL, Dunn LA, Upcroft P, O’Donoghue PJ, Upcroft JA. Drug resistance in the sexually transmitted protozoan Trichomonas vaginalis. Cell Res 2003;13(4):239-249.
Romero-Cabello R, Guerrero LR, Muñoz-García MR, Geyne-Cruz A. Nitazoxanide for the treatment of intestinal protozoan and helminthic infections in Mexico. Trans R Soc Trop Med Hyg 1997;91(6):701-703.
Díaz E, Mondragón J, Ramírez E, Bernal R. Epidemiology and control of intestinal parasites with nitazoxanide in children in Mexico. Am J Trop Med Hyg 2003;68(4):384-385.
Dávila-Gutiérrez CE, Vásquez C, Trujillo-Hernández B, Huerta M. Nitazoxanide compared with quinfamide and mebendazole in the treatment of helminthic infections and intestinal protozoa in children. Am J Trop Med Hyg 2002 Mar;66(3):251-254.
Rodríguez-García, R, Rodríguez-Guzmán LM, Cruz-del Castillo AH. Eficacia y seguridad de mebendazol contra nitazoxanida en el tratamiento de Giardia lamblia en niños. Rev Gastroenterol Mex 1999; 64(3):122-126.
Pengsaa K, Sirivichayakul C, Pojjaroen-anant C, Nimnual S, Wisetsing P. Albendazole treatment for Giardia intestinalis infections in school children. Southeast Asian Journal of Tropical Medicine & Public Health 1999; 30(1):78-83.
Penggabean M, Norhayati O, Oothuman P, Fatmah MS. Efficacy of albendazole in the treatment of Trichuris trichiuria and Giardia intestinalis infection in rural Malay communities. Med J Malaysia. 1998;53(4): 408-412.
Reynoldson JA, Behnke JM, Gracey M, Horton RJ, Spargo R, Hopkins RM. Efficacy of albendazole against Giardia and hookworm in a remote Aboriginal community in the north of Western Australia. Acta Trop 1998 15;71(1):27-44.
Thompson RC, Reynoldson JA, Garrow SC, McCarthy JS, Behnke JM. Towards the eradication of hookworm in an isolated Australian community. Lancet 2001;357(9258):770-771.