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
- *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
E-mail: [email protected]
Received Date: September 16, 2015; Accepted Date: October 16, 2015; Published Date: October 19, 2015
Citation: Sajjad A, Sunil K (2015) Treatment Outcomes with Nitazoxanide in Immunocompetent Adults Naive Patients with Cryptosporidiosis; Do We Need Combination Therapy with Paromomycin or Azithromycin?. Trop Med Surg 3:198. doi:10.4172/2329-9088.1000198
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.
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. Also patients were excluded if they were diagnosed as case of HIV/AIDS, history of solid organ transplantation, any malignancy or were taking steroids and immunosuppressant drugs.
Results: A total of 58 patients who had cryptosporidiosis were included in this study. 31 (53.4%) were males and 27 (46.6%) females. The mean age was 33.4 years with standard deviation ± 9.2. No statistical significance was seen in clinical presentation of cryptosporidiosis in both male and female genders. All 58 (100%) reported resolution of diarrhea after 7 days of nitazoxanide treatment. However, at 6 weeks follow up, 40 (70.1%) patients had recurrence of diarrhea whereas only 17 (29.9%) had no further episode of diarrhea.
Conclusion: Nitazoxanide is a new nitrothiazole compound with broadspectrum activity against numerous intestinal protozoa and helminths and have very good bio-safety profile. All 58 patients after 7 days of treatment with nitazoxanide showed good clinical response after short term. But in long term patients reported a high recurrence in 6 weeks period time. There is need of combination therapy which includes nitazoxanide with paromomycin or azithromycin in high recurrence/relapse patients.