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FORMULARY FORUM

Nitazoxanide Treatment for Giardiasis and Cryptosporidiosis in Children

Pharmacy Ambulatory Care Resident, College of Pharmacy, Idaho State University, Pocatello, ID

John Erramouspe, PharmD MS

Associate Professor of Pharmacy Practice, College of Pharmacy, Idaho State University

Reprints: John Erramouspe PharmD MS, College of Pharmacy, Idaho State University, Pocatello, ID 83209-8333, fax 208/282-4482, johnerra{at}pharmacy.isu.edu

OBJECTIVE: To review the pharmacology, pharmacokinetics, adverse effects, drug interactions, dosing recommendations, and clinical efficacy of nitazoxanide, a new antiprotozoal/anthelmintic/antibacterial agent.

DATA SOURCES: A MEDLINE search (1966–February 2004) of both human and animal research data published in the English language was conducted.

STUDY SELECTION AND DATA EXTRACTION: All primary and review articles pertaining to the MEDLINE search were reviewed for inclusion. Emphasis was placed on randomized, double-blind, placebo-controlled trials.

DATA SYNTHESIS: Nitazoxanide is approved for the treatment of giardiasis and cryptosporidiosis (first drug approved for the latter indication) in immune-competent children <12 years of age. Most studies in immune-competent patients have reported clinical and parasitologic response rates close to 80% and 70%, respectively, for both indications. Response rates have been lower in immune-compromised patients.

CONCLUSIONS: Nitazoxanide should be available for patients unable to tolerate or adhere to first-line therapy employed for these intestinal protozoa.

Key Words: cryptosporidia, giardia, nitazoxanide

Published Online, February 27, 2004. www.theannals.com, DOI 10.1345/aph.1D451

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-04-014-H01