دورية أكاديمية
Nitroimidazole-refractory giardiasis: a growing problem requiring rational solutions.
| العنوان: | Nitroimidazole-refractory giardiasis: a growing problem requiring rational solutions. |
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| المؤلفون: | Carter ER; The Hospital for Tropical Diseases, UK. Electronic address: emma.carter93@icloud.com., Nabarro LE; The Hospital for Tropical Diseases, UK., Hedley L; Pharmacy, University College London Hospitals NHS Foundation Trust, London, UK., Chiodini PL; The Hospital for Tropical Diseases, UK. |
| المصدر: | Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2018 Jan; Vol. 24 (1), pp. 37-42. Date of Electronic Publication: 2017 Jun 15. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: England NLM ID: 9516420 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1469-0691 (Electronic) Linking ISSN: 1198743X NLM ISO Abbreviation: Clin Microbiol Infect Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2015- : London : Elsevier Original Publication: Paris : Decker Europe, c1995- |
| مواضيع طبية MeSH: | Antiprotozoal Agents/*therapeutic use , Drug Resistance/*physiology , Drug Therapy, Combination/*methods , Giardia lamblia/*drug effects , Giardiasis/*drug therapy , Metronidazole/*therapeutic use, Albendazole/therapeutic use ; Chloroquine/therapeutic use ; Giardia lamblia/isolation & purification ; Humans ; Quinacrine/therapeutic use ; Tinidazole/therapeutic use ; Treatment Failure |
| مستخلص: | Background: Giardia intestinalis is microaerophilic diarrhoea-causing protozoan common in countries with suboptimal sanitation. Standard treatment is with nitroimidazoles, but a growing number of refractory cases is being reported. Treatment failure has become increasingly prevalent in travellers who contract giardiasis in Asia. Clinicians are increasingly falling back on second-line and less well-known drugs to treat giardiasis. Aims: To review nitroimidazole-refractory G. intestinalis infection, examine the current efficacy of standard therapeutic agents, consider potential resistance mechanisms which could cause treatment failure and describe the practical aspects of managing this emerging clinical problem. Sources: A PubMed search was conducted using combinations of the following terms: refractory, Giardia, giardiasis, resistance and treatment. Articles on the pharmacotherapy, drug resistance mechanisms and use of alternative agents in nitroimidazole-refractory giardiasis were reviewed. Content: We review the standard drugs for giardiasis, including their efficacy in initial treatment, mode of action and documented in vitro and in vivo drug resistance. We assess the efficacy of alternative drugs in nitroimidazole-refractory disease. Existing data suggest a potential advantage of combination treatment. Implications: An optimal treatment strategy for refractory giardiasis has still to be determined, so there is no standard treatment regimen for nitroimidazole-refractory giardiasis. Further work on drug resistance mechanisms and the use of drug combinations in this condition is a priority. (Copyright © 2017. Published by Elsevier Ltd.) |
| فهرسة مساهمة: | Keywords: Albendazole; Combination treatment; Giardia; Giardiasis; Mepacrine; Metronidazole; Nitroimidazole; Refractorily; Resistance |
| المشرفين على المادة: | 0 (Antiprotozoal Agents) 033KF7V46H (Tinidazole) 140QMO216E (Metronidazole) 886U3H6UFF (Chloroquine) F4216019LN (Albendazole) H0C805XYDE (Quinacrine) |
| تواريخ الأحداث: | Date Created: 20170619 Date Completed: 20180806 Latest Revision: 20220408 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1016/j.cmi.2017.05.028 |
| PMID: | 28624613 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1469-0691 |
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| DOI: | 10.1016/j.cmi.2017.05.028 |