Nitazoxanide for persistent diarrhoea in Zambian acquired immune deficiency syndrome patients: a randomized-controlled trial.
Isaac Zulu,Isaac Zulu,Paul Kelly,Paul Kelly,L. Njobvu,Sandie Sianongo,K. Kaonga,Vincent McDonald,Michael J.G. Farthing,Richard Pollok +9 more
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TLDR
A large number of adults with acquired immune deficiency syndrome and persistent diarrhoea in Zambia have intestinal infection, predominantly protozoa.Abstract:
Summary
Background: Adults with acquired immune deficiency syndrome and persistent diarrhoea in Zambia have intestinal infection, predominantly protozoa.
Aim: To search for treatment which can be offered with minimal investigation, we carried out a double-blind, randomized-controlled trial of nitazoxanide (a drug with a range of activity against parasites and bacteria).
Methods: Patients with diarrhoea of 1 month duration or longer were randomized to receive nitazoxanide (1000 mg twice daily) or placebo for 2 weeks. End-points were clinical response, parasitological clearance and mortality.
Results: Two hundred and seven adults were randomized; 42 died during the study. The primary assessment of efficacy was made after 17 days. Clinical response was observed in 56 (75%) of 75 patients receiving nitazoxanide and 45 (58%) of 77 patients receiving placebo (P = 0.03). The rate of improvement was markedly higher in patients with CD4 counts under 50 cells/μL receiving nitazoxanide (P = 0.007). The benefit was largely restricted to the period when the drug was being administered. No difference was seen in parasitological clearance between the two groups. Mortality was 19% by 4 weeks of follow-up and did not differ with treatment allocation.
Conclusions: Nitazoxanide given orally for 14 days was associated with clinical improvement in Zambian acquired immune deficiency syndrome patients with diarrhoea, especially those with very low CD4 counts.read more
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Antiparasitic drug nitazoxanide inhibits the pyruvate oxidoreductases of Helicobacter pylori, selected anaerobic bacteria and parasites, and Campylobacter jejuni
Paul S. Hoffman,Gary Sisson,Matthew A. Croxen,Kevin D. Welch,W. Dean Harman,Nunilo Cremades,Michael G. Morash +6 more
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High dose prolonged treatment with nitazoxanide is not effective for cryptosporidiosis in HIV positive Zambian children: a randomised controlled trial
Beatrice Amadi,Mwiya Mwiya,Sandie Sianongo,Lara Payne,Angela Watuka,Max Katubulushi,Paul Kelly,Paul Kelly +7 more
TL;DR: This is the second randomised controlled trial to suggest that in Zambian children with HIV-related immunosuppression nitazoxanide does not eradicate this infection nor provide clinical symptom reduction.
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Nitazoxanide: a review of its use in the treatment of gastrointestinal infections.
TL;DR: Nitazoxanide is effective in the treatment of protozoal and helminthic infections, including Cryptosporidium parvum or Giardia lamblia, in immunocompetent adults and children, and is generally well tolerated.
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Treatment of cryptosporidiosis: do we know what we think we know?
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Treatment options for the eradication of intestinal protozoa.
TL;DR: In chronically infected HIV-positive patients, treatment with multidrug regimens usually results in rapid resolution of the diarrhea and, in many instances, eradication of the parasite.
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Early chemoprophylaxis with trimethoprim-sulphamethoxazole for HIV-1-infected adults in Abidjan, Côte d'Ivoire: a randomised trial
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Effect of nitazoxanide on morbidity and mortality in Zambian children with cryptosporidiosis: a randomised controlled trial
Beatrice Amadi,Mwiya Mwiya,John Musuku,Angela Watuka,Sandie Sianongo,Ayman Ayoub,Paul Kelly,Paul Kelly,Paul Kelly +8 more
TL;DR: A 3-day course of nitazoxanide significantly improved the resolution of diarrhoea, parasitological eradication, and mortality in HIV-seronegative, but not HIV-Seropositive, children.
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Treatment of Diarrhea Caused by Cryptosporidium parvum: A Prospective Randomized, Double-Blind, Placebo-Controlled Study of Nitazoxanide
TL;DR: Diarrhea was resolved in most patients receiving nitazoxanide within 3 or 4 days of treatment initiation, and the duration of both diarrhea and oocyst shedding was reduced.
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Threshold of detection of Cryptosporidium oocysts in human stool specimens: evidence for low sensitivity of current diagnostic methods.
TL;DR: The findings suggest that the most commonly used coprodiagnostic techniques may fail to detect cryptosporidiosis in many immunocompromised and Immunocompetent individuals.