Giardiasis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Overview

Patients diagnosed with giardiasis require antimicrobial therapy. Medical therapy for giardiasis includes either metronidazole, albendazole or quinacrine. Furazolidone or nitazoxanide may be used in pediatric patients. Patients must be monitored for the persistence of symptoms following adequate therapy (suggestive of treatment failure) or the re-development of symptoms (recurrence).

Medical Therapy

• Patients diagnosed with giardiasis require antimicrobial therapy.
• Patients must be monitored for the persistence of symptoms following adequate therapy (suggestive of treatment failure) or the re-development of symptoms (recurrence).

Antimicrobial regimen

• 1.1 Adult

• Preferred regimen (1): Metronidazole 250 mg tid 5–7 days
• Preferred regimen (2): Tinidazole 2 g single dose
• Preferred regimen (3): Nitazoxanide 500 mg PO bid (with food)
• Alternative regimen (1): Paromomycin 500 mg tid 3 5–10 days
• Alternative regimen (2): Quinacrine 100 mg tid 3 5–7 days
• Alternative regimen (3): Furazolidone 100 mg qid 3 7–10 days

• 1.2 Pediatric

• Preferred regimen (1): Metronidazole 5 mg/kg tid 3 5–7 days
• Preferred regimen (2): Tinidazole 50 mg/kg single dose (max, 2 g)
• Preferred regimen (3): Nitazoxanide 100 mg PO bid for age 1-3 years or 200 mg PO bid for age 4-11 years (with food)
• Alternative regimen (1): Paromomycin 30 mg/kg/day in 3 doses 3 5–10 days
• Alternative regimen (2): Quinacrine 2 mg/kg tid 3 7 days
• Alternative regimen (3): Furazolidone 2 mg/kg qid 3 10 days