DOCSLIB.ORG

Parasitic Infections (1 of 14)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Parasitic Infections (1 of 14) Parasitic Infections (1 of 14) 1 Patient presents w/ signs & symptoms suggestive of GI parasitic infection 2 DIAGNOSIS No ALTERNATIVE Is a GI parasitic infection DIAGNOSIS confi rmed? Yes Protozoal or helminthic infection? Protozoal Infection Helminthic Infection A Rehydration & nutrition B Prevention PHARMACOLOGICAL PHARMACOLOGICAL THERAPY FOR THERAPY FOR PROTOZOAL HELMINTHIC INFECTIONS INFECTIONS ©See page 3 MIMSSee page 3 B1 © MIMS 2019 Parasitic Infections (2 of 14) 1 SIGNS & SYMPTOMS OF GI PARASITIC INFECTIONS GI Symptoms • Abdominal pain, diarrhea, dysentery, fl atulence, malabsorption, symptoms of biliary obstruction Nonspecifi c Symptoms • Fever, malaise, fatigue, anorexia, sweating, wt loss, edema & pruritus • Some patients may be asymptomatic PARASITIC INFECTIONS PARASITIC 2 DIAGNOSIS Clinical History • Attempt to elicit a history of possible exposure, especially for helminthic infections, eg eating undercooked meat, source of drinking water, swimming in fresh water where certain parasites may be endemic • Knowledge of the geographic distribution of parasites is helpful in the diagnosis of patients Host Susceptibility Factors in GI Parasitic Infections • Nutritional status • Intercurrent disease • Pregnancy • Immunosuppressive drugs • Presence of a malignancy Physical Exam Findings • Pallor • Hepatomegaly • Ascites • Ileus • Rectal prolapse Lab Tests Microscopic Exam of Stools • Fundamental to the diagnosis of all GI infections - A minimum of 3 stool specimens, examined by trained personnel using a concentration & a permanent stain technique, should be used - e stool exam is used to detect protozoan cysts & trophozoites, helminth ova, proglottids, larvae or adult worms - A fecal sample must be mixed well before examination because eggs are never uniformly distributed in feces Other Lab Tests • e following are other tests that may be used to document a GI parasitic infection: - Duodenal aspirate - Biopsy - String capsule test - Immunofl uorescent antibody test - Enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR) - Cellophane tape test - Barium studies • Anemia & eosinophilia may be seen on the complete blood count (CBC) © MIMS B2 © MIMS 2019 Parasitic Infections (3 of 14) PROTOZOAL INFECTIONS C RECOMMENDED THERAPY FOR PROTOZOAN PARASITES Drug Pathogen PARASITIC INFECTIONS PARASITIC Preferred Agents Alternative Agents Cryptosporidium sp (Cryptosporidiosis) Nitazoxanide or - Paromomycin + Azithromycin Entamoeba histolytica (Amoebiasis) Iodoquinol or Paromomycin Diloxanide furoate or • Asymptomatic cyst passer Etofamide E histolytica (Amoebiasis) Metronidazole or Tinidazole Ornidazole or Secnidazole • Mild-moderate intestinal disease E histolytica (Amoebiasis) Metronidazole or Tinidazole Chloroquine or Secnidazole • Severe intestinal disease or liver abscess Giardia lamblia (Giardiasis) In most immunocompetent patients, giardiasis is self-limiting & does not require treatment. In nonendemic areas, asymptomatic carriers of giardiasis are treated Metronidazole Albendazole, Furazolidone, Nitazoxanide, Ornidazole, Paromomycin, Quinacrine, Secnidazole or Tinidazole HELMINTH INFECTIONS D RECOMMENDED THERAPY FOR HELMINTHS Drug Pathogen Preferred Agents Alternative Agents Cestodes (Tapeworms) Taenia saginata, Taenia solium, Praziquantel Niclosamide Diphyllobothrium caninum, Diphyllobothrium latum Nematodes (Roundworms) Ascaris lumbricoides (Ascariasis) Albendazole, Ivermectin, Levamisole, Piperazine or Mebendazole or Nitazoxanide Pyrantel pamoate Ancylostoma duodenale, Necator Albendazole, Mebendazole or Levamisole americanus (Ancylostomiasis) Pyrantel pamoate (Hookworms) Capillaria © philippinensis (Capillariasis) MIMS Mebendazole Albendazole Not all products are available or approved for above use in all countries. Specifi c prescribing information may be found in the latest MIMS. B3 © MIMS 2019 Parasitic Infections (4 of 14) HELMINTH INFECTIONS D RECOMMENDED THERAPY FOR HELMINTHS (CONT’D) Drug Pathogen PARASITIC INFECTIONS PARASITIC Preferred Agents Alternative Agents Nematodes (Roundworms) Enterobius vermicularis (Pinworm or Albendazole, Mebendazole or Piperazine readworm) Pyrantel pamoate Strongyloides stercoralis Albendazole, Ivermectin, - (Strongyloidiasis) Mebendazole or iabendazole Trichuris trichiura (Whipworm) Mebendazole Albendazole, Ivermectin or Nitazoxanide Trematodes (Flukes) Clonorchis sinensis (Oriental liver fl uke) Albendazole or Praziquantel - Fasciola hepatica (Fascioliasis) Bithionol or Triclabendazole Nitazoxanide Fasciolopsis buski, Heterophyes Praziquantel - heterophyes Metagonimus yokogawai (Intestinal fl ukes) Opisthorchis viverrini (Southeast Asian Albendazole or Praziquantel - liver fl uke) Paragonimus westermani (Lung fl ukes) Praziquantel Bithionol Schistosoma haematobium Praziquantel Metrifonate Schistosoma japonicum Praziquantel - Schistosoma mansoni Praziquantel Oxamniquine FOLLOWUP • Repeat lab exams to document eradication of parasite, if necessary A REHYDRATION & NUTRITION Adequate Hydration & Nutrition • Patients w/ parasitic infections frequently suff er from malabsorption, vomiting & diarrhea, resulting in malnutrition • Ensure that patient’s nutritional & hydration status are maintained at acceptable levels Replacement of Fluid & Electrolyte Losses • Vomiting & diarrhea result in fl uid & electrolyte losses, mainly Na & K Blood Transfusion & Treatment w/ FeSO • ese measures© may be necessary in hookwormMIMS infections which may cause severe anemia Not all products are available or approved for above use in all countries. Specifi c prescribing information may be found in the latest MIMS. B4 © MIMS 2019 Parasitic Infections (5 of 14) B PREVENTION • Health education regarding personal hygiene, routes of transmission & prevention of transmission • Handwashing to interrupt the fecal-oral or urinary-oral route of transmission of many parasites • Good food hygiene eg washing all vegetables & fruits before consumption to interrupt fecal-oral transmission - Kitchen utensils must be washed frequently - Meat & fi sh must be properly cooked • Use of footwear to inhibit the soil-to-skin route of infection PARASITIC INFECTIONS PARASITIC • Targeted chemotherapy may prevent infections, like treating family contacts of a patient w/ certain parasitic infections eg enterobiasis • Proper disposal of sewage & wastewater to avoid contamination of food crops or water supplies by fecal material • Compost of human waste to kill infective forms of parasites C TREATMENT FOR PROTOZOAL INFECTIONS Drugs for Treatment of Amoebiasis Luminal Amoebicides • Eg Diloxanide furoate, Iodoquinol, Paromomycin • ese agents are eff ective in treating organisms in the bowel lumen - May be used in patients w/ asymptomatic E histolytica infection • Recommended for asymptomatic cyst passers - To avoid the risk of developing invasive disease - To prevent secondary spread • When asymptomatic cyst carriage persists after treatment for amoebic dysentery or liver abscess, further treatment w/ a luminal amoebicide is mandatory, otherwise relapse is frequent • Paromomycin - Acts directly on amoeba w/ antibacterial activity against normal & pathogenic organisms in GI tract; binds to 30s ribosomal subunits interfering w/ bacterial protein synthesis - Temporarily eliminates diarrhea in human immunodefi ciency virus (HIV) patients who have cryptosporidiosis - May also be used in treatment of cryptosporidiosis & giardiasis Tissue Amoebicides • Eg Chloroquine & Nitroimidazole derivatives (Metronidazole, Nimorazole, Ornidazole, Secnidazole & Tinidazole) • ese agents are eff ective in treating invasive amoebiasis but are less eff ective in treating organisms in the bowel lumen • Chloroquine binds & inhibits DNA & RNA polymerase; it also raises parasite’s internal pH, restricting its growth • Nitroimidazole derivatives cause damage to parasite DNA helical structure resulting in strand breakage & impaired template function Other Antiprotozoan Drugs • Eg Furazolidone, Nitazoxanide, Quinacrine Furazolidone • Used for the treatment of giardiasis • Furazolidone is as eff ective as Metronidazole in the treatment of giardiasis • Action: Causes damage to intracellular components Nitazoxanide • Action: Inhibits growth of sporozoites & oocysts of Cryptosporidium sp & trophozoites of G lamblia Quinacrine (Mepacrine) • Action: Suggested action is binding to parasite DNA thereby inhibiting RNA transcription & protein translation© MIMS Not all products are available or approved for above use in all countries. Specifi c prescribing information may be found in the latest MIMS. B5 © MIMS 2019 Parasitic Infections (6 of 14) D TREATMENT FOR HELMINTHIC INFECTIONS Anthelminthic Drugs Albendazole • Has an exceptionally broad spectrum of antiparasitic activity • Widely used for intestinal nematode infections • Decreases ATP production in worms Bithionol PARASITIC INFECTIONS PARASITIC • Preferred agent for F hepatica • Release of worm antigens may cause reactions eg urticaria, photosensitivity reactions & GI symptoms Ivermectin • As eff ective as iabendazole against S stercoralis but has fewer untoward eff ects • Action: Causes hyperpolarization of muscle & nerve cells of parasite leading to paralysis Levamisole • Action: Causes muscle paralysis in susceptible worms Mebendazole • Widely used for treatment of intestinal nematodes • Poorly absorbed from the GI tract resulting in a low frequency of side eff ects • Action: Blocks glucose and nutrient uptake irreversibly in susceptible worms Metrifonate • Alternative to Praziquantel in the treatment of S haematobium
Load more

Recommended publications
  • The National Drugs List
    ^ ^ ^ ^ ^[ ^ The National Drugs List Of Syrian Arab Republic Sexth Edition 2006 ! " # "$ % &'() " # * +$, -. / & 0 /+12 3 4" 5 "$ . "$ 67"5,) 0 " /! !2 4? @ % 88 9 3: " # "$ ;+<=2 – G# H H2 I) – 6( – 65 : A B C "5 : , D )* . J!* HK"3 H"$ T ) 4 B K<) +$ LMA N O 3 4P<B &Q / RS ) H< C4VH /430 / 1988 V W* < C A GQ ") 4V / 1000 / C4VH /820 / 2001 V XX K<# C ,V /500 / 1992 V "!X V /946 / 2004 V Z < C V /914 / 2003 V ) < ] +$, [2 / ,) @# @ S%Q2 J"= [ &<\ @ +$ LMA 1 O \ . S X '( ^ & M_ `AB @ &' 3 4" + @ V= 4 )\ " : N " # "$ 6 ) G" 3Q + a C G /<"B d3: C K7 e , fM 4 Q b"$ " < $\ c"7: 5) G . HHH3Q J # Hg ' V"h 6< G* H5 !" # $%" & $' ,* ( )* + 2 ا اوا ادو +% 5 j 2 i1 6 B J' 6<X " 6"[ i2 "$ "< * i3 10 6 i4 11 6! ^ i5 13 6<X "!# * i6 15 7 G!, 6 - k 24"$d dl ?K V *4V h 63[46 ' i8 19 Adl 20 "( 2 i9 20 G Q) 6 i10 20 a 6 m[, 6 i11 21 ?K V $n i12 21 "% * i13 23 b+ 6 i14 23 oe C * i15 24 !, 2 6\ i16 25 C V pq * i17 26 ( S 6) 1, ++ &"r i19 3 +% 27 G 6 ""% i19 28 ^ Ks 2 i20 31 % Ks 2 i21 32 s * i22 35 " " * i23 37 "$ * i24 38 6" i25 39 V t h Gu* v!* 2 i26 39 ( 2 i27 40 B w< Ks 2 i28 40 d C &"r i29 42 "' 6 i30 42 " * i31 42 ":< * i32 5 ./ 0" -33 4 : ANAESTHETICS $ 1 2 -1 :GENERAL ANAESTHETICS AND OXYGEN 4 $1 2 2- ATRACURIUM BESYLATE DROPERIDOL ETHER FENTANYL HALOTHANE ISOFLURANE KETAMINE HCL NITROUS OXIDE OXYGEN PROPOFOL REMIFENTANIL SEVOFLURANE SUFENTANIL THIOPENTAL :LOCAL ANAESTHETICS !67$1 2 -5 AMYLEINE HCL=AMYLOCAINE ARTICAINE BENZOCAINE BUPIVACAINE CINCHOCAINE LIDOCAINE MEPIVACAINE OXETHAZAINE PRAMOXINE PRILOCAINE PREOPERATIVE MEDICATION & SEDATION FOR 9*: ;< " 2 -8 : : SHORT -TERM PROCEDURES ATROPINE DIAZEPAM INJ.
    [Show full text]
  • Efficacy and Tolerability of Quinacrine Monotherapy and Albendazole Plus Chloroquine Combination Therapy in Nitroimidazole-Refractory Giardiasis: a Tropnet Study
    Klinik für Infektiologie & Spitalhygiene Efficacy and tolerability of quinacrine monotherapy and albendazole plus chloroquine combination therapy in nitroimidazole-refractory giardiasis: a TropNet study Andreas Neumayr, Mirjam Schunk, Caroline Theunissen, Marjan Van Esbroeck, Matthieu Mechain, Manuel Jesús Soriano Pérez, Kristine Mørch, Peter Sothmann, Esther Künzli, Camilla Rothe, Emmanuel Bottieau Journal Club 01.03.21 Andreas Neumayr Background on giardia treatment: • 1st-line treatment: 5-nitroimidazoles: metronidazole (1957), tinidazole, ornidazole, secnidazole • cure rate of 5NIs in 1st-line treatment: ~90% • in the last decade, an increase of 5NI-refractory giardia cases has been observed in travel medicine clinics across Europe: Hospital for Tropical Diseases, London: 2008: 15% --> 2013: 40% 70% of 5NI-refractory cases imported from India • 2nd-line treatment: effectiveness of a 2nd round with a 5NI: ~17% alternative drugs: albendazole, mebendazole, nitazoxanide, quinacrine, furazolidone, chloroquine, paromomycin 2012 TropNet member survey: 53 centres use 39 different treatment regimens, consisting of 7 different drugs in mono- or combination-therapy in various dosages and durations JC 01.03.21 Nabarro LE et al. Clin Microbiol Infect. 2015;21:791-6. • by 2013, there were only 13 reports of 2nd-line therapy for giardiasis (8 case series, 5 individual case reports): n=110 Cure rates Albendazole 6/32 18.7% Paromomycin 5/17 29.4% Nitazoxanide 2/5 40.0% Albendazole + 5-NI 42/53 79.2% Quinacrine 19/21 90.5% Quinacrine + 5-NI 14/14 100% Quinacrine + Paromomycin 2/2 100% • 2013: TropNet "GiardiaREF" study kick-off: Study on efficacy and tolerability of two 2nd-line regimens in nitroimidazole-refractory giardiasis: Quinacrine JC 01.03.21 Meltzer E et al.
    [Show full text]
  • Jos Journal 2
    POST-OPERATIVE AUDIT OF G6PD-DEFICIENT MALE CHILDREN WITH OBSTRUCTIVE ADENOTONSILLAR ENLARGEMENT AT UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA. John EN1, Totyen EL1, Jacob N2, Nwaorgu OGB1 1 .Department of ENT/Head and Neck Surgery, University College Hospital, Ibadan, Nigeria 2. Department of paediatrics, University College Hospital, Ibadan, Nigeria All correspondences and request for reprint to Dr John EN, Department of ENT/Head and Neck Surgery, University College Hospital, Ibadan, Nigeria Email: [email protected] Telephone: +2348036240109 Abstract Background: G6PD deficiency ranks among the commonest hereditary enzyme deficiency worldwide and notable as a predisposing condition to haemolyticcrises. The fear of possible untoward effects is often expressed by parents of G6PD deficient male children scheduled for surgery after obtaining an informed and understood consent. The parental perception of obstructive adenotonsillar enlargement in this condition was also appraised. Methods: A retrospective chart review of all G6PD deficient male children between ages 1 to 7years who had adenotonsillectomy over a 3year period at University college Hospital, Ibadan, Nigeria. Results: The patients comprised of 22 G6PD deficient male children diagnosed shortly after birth upon development of neonatal jaundice. Fifteen(68.2%) and 6(27.3%) of the patients subsequently developed episodes of drug- induced haemolysis and non-haemolytic drug reactions prior to undergoing adenotonsillectomy by the otolaryngologists. None of the patients was observed to develop haemolytic crises up to 2weeks post-adenotonsillectomy. From the parental perception and responses in the follow-up period,all 22(100%) patient had resolution of noisy breathing, 20(91%) had improvement of snoring and apnoeic spells. Only 15 (68%) were reported to stop mouth-breathing.
    [Show full text]
  • Chemotherapy of Gastrointestinal Helminths
    Chemotherapy of Gastrointestinal Helminths Contributors J. H. Arundel • J. H. Boersema • C. F. A. Bruyning • J. H. Cross A. Davis • A. De Muynck • P. G. Janssens • W. S. Kammerer IF. Michel • M.H. Mirck • M.D. Rickard F. Rochette M. M. H. Sewell • H. Vanden Bossche Editors H. Vanden Bossche • D.Thienpont • P.G. Janssens UNIVERSITATS- BlfiUOTHElC Springer-Verlag Berlin Heidelberg New York Tokyo Contents CHAPTER 1 Introduction. A. DAVIS A. Pathogenic Mechanisms in Man 1 B. Modes of Transmission 2 C. Clinical Sequelae of Infection 3 D. Epidemiological Considerations 3 E. Chemotherapy 4 F. Conclusion 5 References 5 CHAPTER 2 Epidemiology of Gastrointestinal Helminths in Human Populations C. F. A. BRUYNING A. Introduction 7 B. Epidemiological or "Mathematical" Models and Control 8 C. Nematodes 11 I. Angiostrongylus costaricensis 11 II. Anisakis marina 12 III. Ascaris lumbricoides 14 IV. Capillaria philippinensis 21 V. Enterobius vermicularis 23 VI. Gnathostoma spinigerum 25 VII. Hookworms: Ancylostoma duodenale and Necator americanus . 26 VIII. Oesophagostoma spp 32 IX. Strongyloides stercoralis 33 X. Ternidens deminutus 34 XI. Trichinella spiralis 35 XII. Trichostrongylus spp 38 XIII. Trichuris trichiura 39 D. Trematodes 41 I. Echinostoma spp 41 II. Fasciolopsis buski 42 III. Gastrodiscoides hominis 44 IV. Heterophyes heterophyes 44 V. Metagonimus yokogawai 46 X Contents E. Cestodes 47 I. Diphyllobothrium latum 47 II. Dipylidium caninum 50 III. Hymenolepis diminuta 51 IV. Hymenolepis nana 52 V. Taenia saginata 54 VI. Taenia solium 57 VII. Cysticercosis cellulosae 58 References 60 CHAPTER 3 Epidemiology and Control of Gastrointestinal Helminths in Domestic Animals J. F. MICHEL. With 20 Figures A. Introduction 67 I.
    [Show full text]
  • Annex 4: Drug Dosages for Children (Formulary)
    Medicines Dosage Form Dose according to body weight (calculate if weight is below or over) 3-6 kg 6-10 kg 10-15 kg 15-20 kg 20-29 kg albendazole 200 mg (half tablet) 12-24 months chewable tablet, 400mg 400 mg (one tablet) over 24 months amodiaquine 10 mg base/kg/3 days (total dose 30 mg base/kg) tablet, 200mg - - 1 1 1 amoxicillin 15 mg/kg/dose for 7 days tablet/capsule 250 mg ¼ ½ ¾ 1 1½ oral suspension, 125mg/5ml 2.5 ml 5 ml 7.5 ml 10 ml - non-severe pneumonia: 25 mg/kg 2 times per day for 3 days tablet/capsule 250 mg ½ 1 1½ 2 2½ oral suspension, 125mg/5ml 5 ml 10 ml 15 ml - - ampicillin IM 50 mg/kg/6 hours Vial of 500 mg mixed with 2.1 ml 1 ml 2 ml 3 ml 5 ml 6 ml sterile water to give 500 mg/2.5 ml artemether IM 3.2 mg/kg once on day 1 injection, 40mg/ml in 1ml ampoule then injection, 80mg/ml in 1ml ampoule see Chapter 5, management of the child with malaria IM 1.6 mg/kg daily until oral therapy is possible, total therapy one week artemether + fixed dose treatment (20+120 mg) twice daily for 3 days tablet 10+120 mg see Chapter 5, management of the child with malaria lumefantrine artesunate severe malaria: IV or IM 2.4 mg/kg over 3 minutes at 0, 12 and 24 vial of 60 mg in 0.6 ml with 3.4 ml hours on day 1.
    [Show full text]
  • Antibiotic Dispensation Without a Prescription Worldwide: a Systematic Review
    antibiotics Review Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review Ana Daniela Batista 1, Daniela A. Rodrigues 2 , Adolfo Figueiras 3,4,5 , Maruxa Zapata-Cachafeiro 3,4 ,Fátima Roque 2,6 and Maria Teresa Herdeiro 7,* 1 Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; [email protected] 2 Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI/IPG), 6300-559 Guarda, Portugal; [email protected] (D.A.R.); [email protected] (F.R.) 3 Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15702 Santiago de Compostela, Spain; adolfo.fi[email protected] (A.F.); [email protected] (M.Z.-C.) 4 Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), 28001 Madrid, Spain 5 Health Research Institute of Santiago de Compostela (IDIS), 15702 Santiago de Compostela, Spain 6 Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal 7 Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal * Correspondence: [email protected] Received: 7 October 2020; Accepted: 6 November 2020; Published: 7 November 2020 Abstract: Antibiotic resistance still remains a major global public health problem and the dispensing of antibiotics without a prescription at community pharmacies is an important driver of this. MEDLINE, Pubmed and EMBASE databases were used to search and identify studies reporting the dispensing of non-prescribed antibiotics in community pharmacies or drugstores that sell drugs for human use, by applying pharmacy interviews/questionnaires methods and/or simulated patient methods.
    [Show full text]
  • Safety and Efficacy of Nitazoxanide-Based Regimen for the Eradication of Helicobacter Pylori Infection: a Systematic Review and Meta-Analysis
    Original Article Gastroenterol Res. 2020;13(6):260-268 Safety and Efficacy of Nitazoxanide-Based Regimen for the Eradication of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis Umair Iqbala, g, Harshit S. Kharaa, Daud Akhtarb, Yirui Huc, Hafsa Anward, Khwaja F. Haqe, Hafiz U. Siddiquif, Marika K. Bergenstocka, Matthew J. Shellenbergera Abstract eradication regimens revealed a pooled eradication rate of 85% (95% CI: 69-94%) without heterogeneity. In a subgroup analysis, highest Background: Helicobacter pylori (HP) is the most common cause of eradication rates were achieved with levofloxacin, doxycycline, nita- gastritis worldwide. Clarithromycin-based triple therapy or bismuth- zoxanide and proton pump inhibitor with a pooled eradication rate of based quadruple therapy is usually considered the first-line treatment, 92% (88-95%). however with around 30% failure rate for both regimens. Drug re- Conclusion: Nitazoxanide-based regimen is safe and effective in the sistance of clarithromycin and metronidazole is a growing concern eradication of HP infection. It is also successful as a salvage therapy in some parts of the world. Therefore, there is a need for effective in patients who have failed prior treatments. eradication regimen for HP. Nitazoxanide, a bactericidal thiazolide antibiotic, has been shown to be effective in HP infection. We con- Keywords: Nitazoxanide; Helicobacter pylori; Eradication regimen; ducted a systematic review and meta-analysis to evaluate the efficacy Meta-analysis of nitazoxanide-based regimen for the eradication of HP. Methods: We have searched PubMed, Embase, Ovid Medline and Cochrane library database from inception to December 9, 2020 to identify studies that utilized nitazoxanide in the treatment regimen Introduction for HP eradication.
    [Show full text]
  • WO 2012/148799 Al 1 November 2012 (01.11.2012) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2012/148799 Al 1 November 2012 (01.11.2012) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 9/107 (2006.01) A61K 9/00 (2006.01) kind of national protection available): AE, AG, AL, AM, A 61 47/10 (2006.0V) AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, (21) International Application Number: DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, PCT/US2012/034361 HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, KR, (22) International Filing Date: KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, 20 April 2012 (20.04.2012) MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SC, SD, (25) Filing Language: English SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, (26) Publication Language: English TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: (84) Designated States (unless otherwise indicated, for every 61/480,259 28 April 201 1 (28.04.201 1) US kind of regional protection available): ARIPO (BW, GH, GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, (71) Applicant (for all designated States except US): BOARD UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, OF REGENTS, THE UNIVERSITY OF TEXAS SYS¬ TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, TEM [US/US]; 201 West 7th St., Austin, TX 78701 (US).
    [Show full text]
  • Simultaneous Determination of Some Antiprotozoal Drugs in Different
    Abdelaleem and Abdelwahab Chemistry Central Journal 2012, 6:27 http://journal.chemistrycentral.com/content/6/1/27 RESEARCHARTICLE Open Access Simultaneous determination of some antiprotozoal drugs in different combined dosage forms by mean centering of ratio spectra and multivariate calibration with model updating methods Eglal A Abdelaleem and Nada S Abdelwahab* Abstract Background: Metronidazole (MET) and Diloxanide Furoate (DF), act as antiprotozoal drugs, in their ternary mixtures with Mebeverine HCl (MEH), an effective antispasmodic drug. This work concerns with the development and validation of two simple, specific and cost effective methods mainly for simultaneous determination of the proposed ternary mixture. In addition, the developed multivariate calibration model has been updated to determine Metronidazole benzoate (METB) in its binary mixture with DF in Dimetrol® suspension. Results: Method (I) is the mean centering of ratio spectra spectrophotometric method (MCR) that depends on using the mean centered ratio spectra in two successive steps that eliminates the derivative steps and therefore the signal to noise ratio is enhanced. The developed MCR method has been successfully applied for determination of MET, DF and MEH in different laboratory prepared mixtures and in tablets. Method (II) is the partial least square (PLS) multivariate calibration method that has been optimized for determination of MET, DF and MEH in Dimetrol ® tablets and by updating the developed model, it has been successfully used for prediction of binary mixtures of DF and Metronidazole Benzoate ester (METB) in Dimetrol ® suspension with good accuracy and precision without reconstruction of the calibration set. Conclusion: The developed methods have been validated; accuracy, precision and specificity were found to be within the acceptable limits.
    [Show full text]
  • Albendazole: a Review of Anthelmintic Efficacy and Safety in Humans
    S113 Albendazole: a review of anthelmintic efficacy and safety in humans J.HORTON* Therapeutics (Tropical Medicine), SmithKline Beecham International, Brentford, Middlesex, United Kingdom TW8 9BD This comprehensive review briefly describes the history and pharmacology of albendazole as an anthelminthic drug and presents detailed summaries of the efficacy and safety of albendazole’s use as an anthelminthic in humans. Cure rates and % egg reduction rates are presented from studies published through March 1998 both for the recommended single dose of 400 mg for hookworm (separately for Necator americanus and Ancylostoma duodenale when possible), Ascaris lumbricoides, Trichuris trichiura, and Enterobius vermicularis and, in separate tables, for doses other than a single dose of 400 mg. Overall cure rates are also presented separately for studies involving only children 2–15 years. Similar tables are also provided for the recommended dose of 400 mg per day for 3 days in Strongyloides stercoralis, Taenia spp. and Hymenolepis nana infections and separately for other dose regimens. The remarkable safety record involving more than several hundred million patient exposures over a 20 year period is also documented, both with data on adverse experiences occurring in clinical trials and with those in the published literature and\or spontaneously reported to the company. The incidence of side effects reported in the published literature is very low, with only gastrointestinal side effects occurring with an overall frequency of just "1%. Albendazole’s unique broad-spectrum activity is exemplified in the overall cure rates calculated from studies employing the recommended doses for hookworm (78% in 68 studies: 92% for A. duodenale in 23 studies and 75% for N.
    [Show full text]
  • The Nitroimidazole Family of Drugs
    Br J Vener Dis: first published as 10.1136/sti.54.2.69 on 1 April 1978. Downloaded from British Journal of Venereal Diseases, 1978, 54, 69-71 Editorial The nitroimidazole family of drugs In 1955 an antibiotic complex isolated from a operative infection caused by susceptible anaerobes, strain of Streptomyces on the island of Reunion particularly in gynaecological surgery, appendi- was found by research workers of Rhone-Poulenc in cectomy, and colonic surgery. Paris to contain a trichomonacidal antibiotic- Real innovations in chemotherapy, such as azomycin. It had previously been isolated in Japan metronidazole, always attract attention from other (Maeda et al., 1953) and identified as 2-nitroimi- research groups. Although interest was slow to dazole (Ia see Table) (Nakamura, 1955). At the develop, research workers have sought analogous, time, and for some years after, this remarkably structurally-modified compounds which might afford simple compound defied synthesis, but it stimulated some advantage in clinical use-for example, the workers at Rhone-Poulenc to prepare and test greater potency, better tolerance and freedom from the activity of the more readily accessible isomeric side effects, a broader spectrum of action, a longer 5-nitroimidazoles (II). It was their good fortune in duration of action, or in some other characteristic. 1957 to find that these isomers were more active This effort has been concerned with important antiprotozoal agents than the natural product veterinary uses of 5-nitroimidazoles as well as the (Cosar and Julou, 1959). In a series of 150 related applications in human medicine. compounds, the one with a P-hydroxyethyl group Metronidazole has been a difficult target to in the 1-position gave the best compromise between improve upon, but several other drugs of this activity and toxicity and this brand of metroni- chemical family have been introduced to clinical dazole was introduced as Flagyl.
    [Show full text]
  • Treatment Outcomes with Nitazoxanide in Immunocompetent
    dicine & Me S l u a r ic g e p r o y r T Ali and Kumar, Trop Med Surg 2015, 3:4 Tropical Medicine & Surgery DOI: 10.4172/2329-9088.1000198 ISSN: 2329-9088 Research Article Open Access Treatment Outcomes with Nitazoxanide in Immunocompetent Adults Naive Patients with Cryptosporidiosis; Do We Need Combination Therapy with Paromomycin or Azithromycin? Sajjad Ali1* and Sunil Kumar2 1Chairman Infection Prevention and Control Department, Department of Internal Medicine/Infectious Diseases, Sultan Bin AbdulAziz Humanitarian City Hospital, Riyadh, Saudi Arabia 2Department of Infectious Diseases, Sindh Institute of Urology and Transplantation, Karachi, Pakistan *Corresponding author: Sajjad Ali, Chairman Infection Prevention and Control Department, Department of Internal Medicine/Infectious Diseases, Sultan Bin AbdulAziz Humanitarian City Hospital, Riyadh, Saudi Arabia, Tel: 00966115620000; E-mail: [email protected] Received date: September 16, 2015, Accepted date: October 16, 2015, Published date: October 19, 2015 Copyright: © 2015 Sajjad, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. Abstract Introduction: Human cryptosporidiosis is caused by infection with Cryptosporidium. Nitazoxanide has shown activity against cryptosporidium. The objective of this study is to see treatment outcomes with 7 days of nitazoxanide in immunocompetent adult patients diagnosed with cryptosporidiosis and to consider combination therapy which includes nitazoxanide with paromomycin or azithromycin? Study Design: This cross sectional study was conducted at Sindh Institute of Urology and Transplantation, Karachi Pakistan. Patients were not enrolled with prior diagnosis of cryptosporidiosis and/or had taken Nitazoxanide, Paromomycin or Azithromycin in last 4 weeks prior their diagnosis.
    [Show full text]