Efficacy of saccharomyces boulardii with antibiotics in acute amoebiasis. Short course of single daily dosage treatment with tinidazole and metronidazole in intestinal amoebiasis: a comparative study. Efficacy and Safety of Quinfamide versus Secnidazole in the Management of Amoebic Non-Dysenteric Colitis in Children. Tinidazole and metronidazole in the treatment of intestinal amoebiasis. [CHRONIC INTESTINAL AMEBIASIS. THERAPEUTIC TRIAL OF ANTIBIOTICS, CHEMOTHERAPEUTICS AND PLACEBOS]. Clinical trial of Ro7-0207, a nitroimidazole derivative in amoebic dysentery. Comparative Study of the Efficacy and Tolerability of Secnidazole Suspension (single dose) and Tinidazole Suspension (two days dosage) in the Treatment of Amebiasis in Children. Nitazoxanide compared with quinfamide and mebendazole in the treatment of helminthic infections and intestinal protozoa in children. Chlorhydroxyquinoline and di-iodohydroxyquinoline in amoebiasis: a comparative study. Comparison of four nitroimidazole compounds for treatment of symptomatic amoebiasis in Kenya. Tinidazole versus Ornidazole in amebic dysentery in children (a double blind trial). Comparison between the efficacy of a single dose of secnidazole with a 5-day course of tetracycline and clioquinol in the treatment of acute intestinal amoebiasis. Comparative study of aminosidine, etophamide and nimorazole, alone or in combination, in the treatment of intestinal amoebiasis in Kenya. Treatment of diarrhea caused by Giardia intestinalis and Entamoeba histolytica or E. dispar: a randomized, double-blind, placebo-controlled study of nitazoxanide. Nitazoxanide in the treatment of amoebiasis. Treatment of non-invasive amoebiasis--a comparison between tinidazole and metronidazole. Treatment of non-invasive amoebiasis. A comparison between tinidazole alone and in combination with diloxanide furoate. Treatment of intestinal amoebiasis and vaginal trichomoniasis with panidazole and its comparison with metronidazole. Double blind study with a new nitroimidazole derivative, Ro 7-0207, versus metronidazole in symptomatic intestinal amebiasis. Ornidazole and secnidazole in the treatment of symptomatic intestinal amoebiasis in childhood. Treatment of children with acute amoebic dysentery. Comparative trial of metronidazole against a combination of dehydroemetine, tetracycline, and diloxanide furoate. Oral chemotherapy in amoebic dysentery--potentiating effect of chloroquine on the action of diloxanide furoate. A new oral amoebicid (RO 7-0207) in the treatment of intestinal amoebiasis. Minute treatment with tinidazole and ornidazole in children with amebic dysentery. A comparison of a short course of single daily dosage therapy of tinidazole with metronidazole in intestinal amoebiasis. Comparative trial of tinidazole and metronidazole in intestinal amebiasis. Evaluation of 1-methyl-2-(4'-fluorophenyl)-5-nitroimidazole.
To compare the efficacy of antibiotics therapy alone with antibiotics and saccharomyces boulardii in treatment of acute amebiasis.
                In a double blind, random clinical trial on patients with acute intestinal amoebiasis, 57 adult patients with acute amoebiasis, diagnosed with clinical manifestations (acute mucous bloody diarrhea) and amebic trophozoites engulfing RBCs found in stool were enrolled in the study. Regimen 1 included metronidazole (750 mg Tid) and iodoquinol (630 mg Tid) for 10 days. Regimen 2 contained capsules of lyophilized saccharomyces boulardii (250 mg Tid) orally in addition to regimen 1. Patients were re-examined at two and four weeks after the treatment, and stool examination was performed at the end of week 4. Student's t-test, chi(2) and McNemar's tests were used for statistical analysis.
                Three patients refused to participate. The other 54 patients were randomized to receive either regimen 1 or regimen 2 (Groups 1 and 2 respectively, each with 27 patients). The two groups were similar regarding their age, sex and clinical manifestations. In Group 1, diarrhea lasted 48.0+/-18.5 hours and in Group 2, 12.0+/-3.7 hours (P<0.0001). In Group 1, the durations of fever and abdominal pain were 24.0+/-8.8 and 24.0+/-7.3 hours and in Group 2 they were 12.0+/-5.3 and 12.0+/-3.2 hours, respectively (P<0.001). Duration of headache was similar in both groups. At week 4, amebic cysts were detected in 5 cases (18.5 %) of Group 1 but in none of the Group 2 (P<0.02).
                Adding saccharomyces boulardii to antibiotics in the treatment of acute amebiasis seems to decrease the duration of clinical symptoms and cyst passage. Tinidazole or metronidazole was administered at random to 56 patients with symptomatic intestinal amoebiasis. The dose of each drug given was 2 g once daily for 3 consecutive days. Tinidazole cured 92.6% patients (25/27) and metronidazole 58.6% patients (17/29). The difference was statistically significant (p less than 0.01). Tinidazole was better tolerated compared with metronidazole. Objective: To compare the efficacy and safety of single doses of quinfamide and secnidazole in the treatment of amoebic non-dysenteric colitis in children. Design: This was a prospective, longitudinal, double-blind, randomised, comparative study. Setting: The participants were students or relatives of students at two urban elementary schools in Celaya, Guanajuato, Mexico. Participants: Patients aged between 2 and 15 years of age with cysts of Entamoeba histolytica in stool samples for 3 consecutive days as detected by Faust's concentration method were enrolled in this study. Interventions and Outcome Measures: Single doses of quinfamide 4.3 mg/kg or secnidazole 30 mg/kg were administered. Patients were asked about the acceptability of the flavour of the drugs. Efficacy was evaluated by the presence or absence of E. histolytica cysts in stool samples on the fifth, sixth and seventh days after administration of the drugs. Adverse events were evaluated by direct questioning of patients. Results: 734 patients were evaluated by coproparasitoscopy, of whom 239 (32.6%) had E. histolytica cysts. 112 patients were randomised to receive quinfamide and 127 to receive secnidazole. Differences in age, bodyweight, size and gender distribution were not statistically significant between the groups. 108 patients (96%) in the quinfamide group and 15 patients (12%) in the secnidazole group reported the flavour as good (p < 0.0001). 95 patients (85%) in the quinfamide group and 93 patients (73%) in the secnidazole group had negative stool samples at the end of treatment (p = 0.04). Nausea (p < 0.0001), abdominal pain (p < 0.05) and unpleasant taste (i.e. metallic taste 3 to 5 days after administration of secnidazole) in mouth (p < 0.0001) were more common in the secnidazole group than in the quinfamide group. Conclusions: Quinfamide is an excellent option for amoebic non-dysenteric colitis because of its high parasitoscopic efficacy, minimum adverse effects and good acceptance by children. The single-dose schedule guarantees completion of treatment. Sixty adult patients with symptomatic intestinal amoebiasis and with Entamoeba histolytica present in stools were allocated at random to treatment with tinidazole or metronidazole, both administered in a dose of 2 g once daily for 3 consecutive days. The treatment period was extended in patients with stools positive for Entamoeba histolytica on the day following the last treatment day. Fifty-six patients, 29 on tinidazole and 27 on metronidazole, completed the trial as per the protocol. Twenty-eight patients (96.5%) on tinidazole and 15 (55.5%) on metronidazole were cured. Parasitological cure with partial relief of symptoms was obtained in 1 (3.5%) and 5 (18.5%) patients on tinidazole and metronidazole, respectively. Seven patients (26%) on metronidazole were treatment failures. Treatment had to be extended beyond 3 day in 53% of patients (8/15) on metronidazole as opposed to 11% (3/28) on tinidazole (p less than 0.01). The total number of side-effects, their severity, and the types were more in the metronidazole group. No toxic effects due to either drug were recorded. Tinidazole provided significantly higher cure rates than metronidazole in the treatment of symptomatic intestinal amoebiasis (p less than 0.01), and was better tolerated than metronidazole. nan nan Amebiasis caused by Entamoeba histolytica may be considered the most aggressive parasitic disease affecting human intestine, causing acute amoebic colitis and extra-intestinal diseases of high morbidity and mortality. 5-nitroimidazoles are the drugs of choice. In this multicenter, open and random clinical trial, the efficacy and tolerability of secnidazole suspension in a single oral dose of 1ml/kg was compared with 0.5ml/kg doses of tinidazole suspension given for 2 consecutive days to 303 Entamoeba histolytica-positive children aged 2 to 13. Patients with extra-intestinal complications were excluded from the study. Clinical and parasitological follow-up using the Faust and Kato-Katz method were carried out 7, 14, and 21 days after treatment. Clinical improvement/cure was observed in 93% of the patients in the secnidazole group and 91% in the tinidazole group. Parasitological success was reported for 77% and 63% of the secnidazole and tinidazole patients, respectively, showing a significant statistical difference between the two groups (p=0.007). Both drugs were well tolerated, and the adverse effects reported were mild, consisting mainly of digestive disturbances. This comparative study showed that a single oral dose of 1ml/kg of secnidazole produced a significantly higher parasitological cure rate than 2 doses of tinidazole. Secnidazole is a safe and effective drug for the treatment of uncomplicated intestinal amebiasis. The present study was carried out to evaluate the effectiveness of nitazoxanide compared with that of quinfamide, mebendazole, or both in the treatment of intestinal protozoa and helminthic infections. A total of 677 stool specimens from children aged 2-12 years living in 3 communities of Colima, México, were analyzed in order to detect the presence of cysts, trophozoites, eggs, or larvae of intestinal protozoa or helminths. A total of 275 infected children were enlisted in a double-blind controlled study and randomly assigned to one of 2 treatment groups: Group A, nitazoxanide (200 mg for 3 days) and Group B, quinfamide (100 mg for 1 day), mebendazole (200 mg for 3 days), or both. A posttreatment fecal examination was conducted on Day 14 from treatment initiation. In Group A (n = 143), the parasitosis eradication rate was superior to that of Group B (n = 132). However, there was no significant difference between the 2 groups (P > 0.05). nan Four antiamoebic drugs currently used in many Kenyan hospitals and health centres were compared for their efficacy on symptomatic luminal amoebiasis in Kiambu, Kilifi, and Machakos hospitals during this study. The drugs were; the brand metronidazole (Flagyl, May & Baker, Kenya Ltd.), the generic metronidazole (Metrozol, Cosmos Ltd., Nairobi, Kenya), the brand tinidazole (Fasigyn, Pfizer Laboratories Ltd.) and the generic tinidazole (Tynazole Laboratory and Allied Equipments, Kenya Ltd). Clinical cure was achieved in all individuals receiving any of the four drugs. Parasitological cure was better for those receiving either Flagyl or Fasigyn, than those receiving the generic counterparts. Both parasitological and clinical cures were achieved in about 50% of all those who received either Flagyl or Fasigyn. It appears that Flagyl and Fasigyn are not as efficacious as previously reported but are still much better than their generic counterparts for the treatment of symptomatic Entamoeba histolytica infections. nan A study was carried out in 80 patients with acute intestinal amoebiasis to compare the efficacy of treatment with a single oral dose of 2 g secnidazole and a 5-day course of 750 mg tetracycline plus 1 g clioquinol per day. Patients were allocated at random into one or other treatment group and returned for clinical assessment and microscopic examination of stools for the presence of the trophozoite or haematophagous form of Entamoeba histolytica on Days 1 to 7, 14, 21 and 28. The results showed that secnidazole produced significantly faster and more effective treatment than tetracycline/clioquinol. At the end of the follow-up period, 7 of the 40 patients in the tetracycline/clioquinol group were classified as 'parasitological' failures but there were none in the secnidazole group. Moreover, there were no cases of relapse or persistence of clinical signs in the secnidazole-treated patients. Both treatments were well tolerated. 417 patients suffering from intestinal amoebiasis were randomly allocated to 6 different treatment groups in a controlled study in 3 District Hospitals in Kenya. The patients received either aminosidine (A), etophamide (E), nimorazole (N), or the combinations NA, NE, EA. Treatment in all cases was given twice daily for 5 days. Before and after treatment, rectosigmoidoscopy was done in each patient, and stool examination with characterization of invasive (IF) and non invasive (NIF) forms of amoeba was done daily throughout treatment, and on Days 15, 30 and 60 of follow-up. Clinical cure was good after all the treatments, varying from 90 to 100%; parasitological cure at the end of treatment was 100% in the NA and EA treatments groups, and 98% in A group. The incidence of relapses was nil in the EA group, followed by 3% in NA and 6% in A groups. Anatomical cure (healing of ulcers) was 97.8% in the NA group, 95.5% in the N group and 88.5% in the A group. Drug tolerance was excellent or good after all the treatments, except that the EA combination produced diarrhoea in 76.5% of patients. Overall analysis of the findings, including tolerance of the various treatments, showed that aminosidine either alone or in combination with nimorazole gave the best results. Ulcers seen on rectosigmoidoscopy were more common in patients excreting invasive forms of amoebae in their stools. A prospective randomized, double-blind, placebo-controlled study was conducted to assess the efficacy and safety of nitazoxanide in the treatment of diarrhea caused by Giardia intestinalis or Entamoeba histolytica and/or E. dispar in 89 adults and adolescents, 22 of whom were diagnosed with G. intestinalis, 53 with E. histolytica and/or E. dispar, and 14 with both G. intestinalis and E. histolytica and/or E. dispar. The study medication was administered as 1 nitazoxanide 500-mg tablet or a matching placebo twice daily for 3 days. Thirty-eight (81%) of 47 patients in the nitazoxanide treatment group resolved diarrhea within 7 days (median, 3 days) after initiation of treatment, versus 17 (40%) of 42 in the placebo group (P=.0002). With its efficacy in treating a broad spectrum of enteric protozoan pathogens, nitazoxanide could play an important role in the management of diarrhea caused by enteric protozoa, reducing morbidity and costs associated with these diarrheal illnesses. Amoebiasis is a significant cause of morbidity worldwide and is the third leading cause of death from parasitic diseases. This study evaluated nitazoxanide, a thiazolide anti-infective, in the treatment of intestinal and hepatic amoebiasis. Prospective, randomised, double-blind, placebo-controlled studies were conducted in outpatients with intestinal amoebiasis from the Nile Delta of Egypt. Nitazoxanide was administered twice daily for 3 days at doses of 500mg (age > or =12 years), 200mg (age 4-11 years) or 100mg (age 1-3 years). Seventeen adults hospitalised with hepatic amoebiasis were treated with 500mg nitazoxanide twice daily for 10 days. Four days after completion of therapy, 32 (94%) of 34 nitazoxanide-treated patients with intestinal amoebiasis resolved symptoms compared with 15 (50%) of 30 patients who received placebo (P<0.001). Thirty-two (94%) of 34 nitazoxanide-treated patients were free of Entamoeba histolytica in two post-treatment stool specimens compared with only 13 (43%) of 30 patients receiving placebo (P<0.0001). All patients with hepatic amoebiasis responded to nitazoxanide therapy. Nitazoxanide is effective in treating invasive intestinal amoebiasis and in eliminating E. histolytica colonisation of the intestinal tract. Further studies are warranted in patients with hepatic amoebiasis. In a small pilot study the parasite cure rate (PCR) of non-invasive amoebiasis was compared after treatment with metronidazole 800 mg three times daily or tinidazole 600 mg twice daily for five days. Both treatment regimens were found to be highly unfavourable with PCRs of 44 and nil respectively, in contrast to previous published results showing PCR over 80%. Tinidazole (40 mg/kg body-weight in one daily dose for five days) and tinidazole (same dose) plus diloxanide furoate (20 mg/kg body-weight divided into three daily doses for 10 days) were compared as treatments for amoebiasis. The parasitic cure rates were 44 and 91% respectively. We cannot, therefore, recommend tinidazole alone in this dosage as a treatment for non-invasive amoebiasis. A dose range study in 18 patients suffering from intestinal amoebiasis and treated with doses of panidazole between 1.0 and 2.0 g per day for six days revealed that the best therapeutic results were obtained with the higher dose. This dose was then compared with metronidazole, at the same dose, in a clinical trial in 100 patients with intestinal amoebiasis. Cure rates were 68% and 80% for the two drugs respectively. In 100 cases of vaginal trichomoniasis treated with panidazole at the dose of 1.0 g per day for seven days in half of the patients and for 10 days in the other half, we obtained 50% and 60% cure rates. The results of our studies with both amoebiasis and trichomoniasis were not superior to those obtained with metronidazole and other nitroimidazole derivatives. Side effects were found in 74% of the patients treated for amoebiasis and in 46% of the cases treated for trichomoniasis. No toxic effects were revealed by haematological, biochemical and renal function tests nor by cardiovascular studies. Of 115 patients with symptomatic intestinal amebiasis, 56 were treated with Ro 7-0207 and 59 with metronidazole in a double blind study. Results of treatment were similar in the two groups and side effects were of low intensity except in one patient who received Ro 7-0207 and developed numbness of hands and tongue, difficulty in speaking, and headache. These symptoms disappeared after termination of treatment. nan nan nan nan nan Sixty patients with symptomatic intestinal amoebiasis were treated for 3 days with a single dose of 2 g of either tinidazole or metronidazole respectively by random order. Tinidazole cured 90% of patients (27/30) an metronidazole cured 53.3% of patients (16/30). The difference was significant (p less than 0-01). Mild side-effect were reported by 26-7% of patients (8/30) in the tinidazole group as compared to mild to moderated side-effects reported by 53.3% of patients (16/30) in the metronidazole group. The difference was statistically significant (p less than 0-05). As the average patient has only a limited understanding and toleration of extended treatment courses, the advantages of a short course employing a single daily dose are obvious. With such a regimen, tinidazole was found to be superior to metronidazole in intestinal amoebiasis. nan nan
Tinidazole is more effective in reducing clinical failure compared with metronidazole and has fewer associated adverse events. Combination drug therapy is more effective in reducing parasitological failure compared with metronidazole alone. However, these results are based on trials with poor methodological quality so there is uncertainty in these conclusions. Further trials of the efficacy of antiamoebic drugs, with better methodological quality, are recommended. More accurate tests to detect E. histolytica are needed, particularly in countries where concomitant infection with other bacteria and parasites is common.