Five-nitroimidazole Drugs: Over 50 Years In Use In Human Giardiasis, Are Still Efficacious? | 13303
Clinical Pharmacology & Biopharmaceutics
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For more than 50 years, 5-nitroimidazole (5-NI) drugs, especially metronidazole, have been in use in the treatment of children
and adults with giardiasis. This disease, caused by the flagellated protozoan
, is recognised as a major cause of
parasite-induced diarrhoea, and is currently an important public health problem, placing a heavy burden on both diagnostic and
treatment services at health care institutions, mostly in developing countries, but also in highly industrialized countries. Although
giardiasis has been a threat to mankind for thousands of years, until recently, it was relatively neglected. As a consequence, the
pharmaceutical industry has had few incentives to engage in the development of new drugs and, at present, nitazoxanide is the
first new drug developed for treating giardiasis in more than 20 years. Currently, the increasing number of reports of refractory
cases with 5-NI drugs and other antigiardial agents has raised concern and led to a search for other compounds, some of which
have arisen due to the introduction of drugs initially addressed to other diseases. Information is required to know if 5-NI are still
efficacious in the present context, in which resistance to common antimicrobials is a threat. Additionally, it is discussed some of the
most important points of antigiardial pharmacotherapy available at present and the future prospects of development of new agents.
Angel Escobedo is a Ph.D. student at the Institute ?Pedro Kour?, Cuba. In 2010, the Pan-American Association of Infectology awarded him with the
medal ?Eduardo Gotuzzo? for his research in the field of Infectology. Escobedo has long-standing interest in antimicrobial therapy in giardiasis, and
its public health impact, in which his research have been focused for more than 15 years, with numerous contributions to scientific journals. He is
the vice-chairperson of the Cuban Microbiology and Parasitology Society and represents the Pan-American Association of Infectology in Cuba. He
is involved in clinical research and teaching, particularly Parasitology
, medical undergraduates and postgraduates.
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