Cañete Roberto, Escobedo Angel A, González Maria Elena, Almirall Pedro, Cantelar Nereyda
Cuban Institute of Gastroenterology, Havana City, Cuba.
Curr Med Res Opin. 2006 Nov;22(11):2131-6. doi: 10.1185/030079906X132497.
Giardia duodenalis is the most commonly detected parasite in the intestinal tract of humans and 5-nitroimidazole compounds, quinacrine and furazolidone have been used against giardiasis. However, cases refractory to treatment with these drugs are becoming more common worldwide.
To compare the efficacy and safety of mebendazole versus tinidazole in the treatment of giardiasis.
122 children (aged 5 to 15 years) of both sexes with confirmed Giardia duodenalis cysts or trophozoites in their stool samples were randomly separated into two groups of 61 individuals. Each group received either mebendazole 200 mg three times for 1 day or tinidazole 50 mg/kg in a single dose. The evaluation of the efficacy was based on parasitological response. Parents or legal guardians of each child were asked to provide three fecal samples on days 3, 5, and 7 after treatment completion. A child was considered to be cured if no Giardia trophozoites or cysts were found in any of the three post-treatment fecal specimens evaluated by direct wet mounts and/or after Ritchie concentration techniques.
The frequency of cure was higher for tinidazole (81.97%) than for mebendazole (63.93%); the difference was statistically significant (p < 0.05). Transient abdominal pain was more common in children treated with mebendazole (p < 0.05), whereas loss of appetite, bitter taste, headache, vomiting, and nausea were more common in the tinidazole-treated group (p < 0.05).
Three doses of mebendazole, in a single day, are inferior to a single dose tinidazole in the treatment of giardiasis.
十二指肠贾第虫是人类肠道中最常检测到的寄生虫，5-硝基咪唑类化合物、奎纳克林和呋喃唑酮已被用于治疗贾第虫病。然而，全球范围内对这些药物治疗难治的病例越来越普遍。
比较甲苯达唑与替硝唑治疗贾第虫病的疗效和安全性。
122名5至15岁的儿童，粪便样本中确诊有十二指肠贾第虫囊肿或滋养体，随机分为两组，每组61人。一组接受甲苯达唑200mg，每日三次，共1天；另一组接受替硝唑50mg/kg单剂量治疗。疗效评估基于寄生虫学反应。要求每个孩子的父母或法定监护人在治疗完成后的第3天、第5天和第7天提供三份粪便样本。如果通过直接湿片检查和/或Ritchie浓缩技术评估的三份治疗后粪便标本中均未发现贾第虫滋养体或囊肿，则认为该儿童已治愈。
替硝唑组的治愈率（81.97%）高于甲苯达唑组（63.93%）；差异具有统计学意义（p<0.05）。甲苯达唑治疗的儿童中短暂性腹痛更为常见（p<0.05）；而替硝唑治疗组中食欲不振、口苦、头痛、呕吐和恶心更为常见（p<0.05）。
在治疗贾第虫病方面，一日三次服用甲苯达唑不如单剂量替硝唑。
