Cohen Stanley A
Children's Center for Digestive Health Care, Atlanta, GA 30342, USA.
Curr Med Res Opin. 2005 Jul;21(7):999-1004. doi: 10.1185/030079905X50534.
Despite advances in the management of diarrheal disorders, diarrhea is the second most frequent illness in the world. Persistent diarrhea, common in community pediatrics, is often caused by organisms such as Giardia lamblia, Cryptosporidium parvum and, less frequently, Cyclospora, Isospora belli, and Clostridium difficile. Identifying the causative organism is often challenging, and diagnostic tests may be inaccurate and expensive and, thus, of limited benefit. Consequently, carefully chosen empiric therapy guided by a physician's clinical impressions may be a useful and cost-effective option in children with persistent diarrhea, particularly those whose signs and symptoms suggest a protozoal etiology. This article discusses the empiric use of anti-infective nitazoxanide, a thiazolide compound, in three case reports of children with persistent diarrhea, and presents an overview of the diagnostic and therapeutic issues associated with this disorder and the pharmacodynamics and pharmacokinetics of the drug.
尽管腹泻性疾病的管理取得了进展，但腹泻仍是全球第二常见的疾病。持续性腹泻在社区儿科中很常见，通常由诸如蓝氏贾第鞭毛虫、微小隐孢子虫等病原体引起，较少由环孢子虫、贝氏等孢球虫和艰难梭菌引起。确定病原体往往具有挑战性，诊断测试可能不准确且昂贵，因此益处有限。因此，在患有持续性腹泻的儿童中，尤其是那些体征和症状提示原生动物病因的儿童，由医生的临床印象指导精心选择的经验性治疗可能是一种有用且具有成本效益的选择。本文在三例持续性腹泻儿童的病例报告中讨论了抗感染药物硝唑尼特（一种噻唑啉化合物）的经验性使用，并概述了与该疾病相关的诊断和治疗问题以及该药物的药效学和药代动力学。
