Which medications in the drug class Antiparasitics are used in the treatment of Cryptosporidiosis?

Updated: Nov 11, 2019
  • Author: Melinda B Tanabe, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Antiparasitics

Nitazoxanide is the only FDA-approved treatment for cryptosporidiosis in HIV-negative children and adults. Antiparasitic drugs may be used as an adjunct to therapy in patients with AIDS or organ transplant recipients undergoing immunosuppression. However, the mainstay of therapy is reversal of immunosuppression by antiretroviral drugs in AIDS or reduction of immunosuppressants in transplant recipients.

Nitazoxanide (Alinia)

Nitazoxanide inhibits the growth of Cryptosporidium parvum and Giardia lamblia trophozoites. It elicits antiprotozoal activity by interfering with pyruvate-ferredoxin oxidoreductase (PFOR) enzyme–dependent electron transfer reaction, which is essential to anaerobic energy metabolism. Nitazoxanide is the only medication approved by the FDA for the treatment for cryptosporidiosis in adults and children older than 12 months. It is administered in a 3-day, twice-daily course of tablets or oral suspension.

Paromomycin

Paromomycin is an oral, nonabsorbed aminoglycoside that is partially active in cryptosporidiosis. An amebicidal and antibacterial agent, it is obtained from a strain of Streptomyces rimosus that is active in intestinal amebiasis.

Paromomycin has been used in patients who have AIDS and cryptosporidiosis; it was reported to cause symptomatic improvement but rarely parasite eradication. It has also been used for intestinal tapeworms.

Azithromycin (Zithromax, Zmax)

Azithromycin is a macrolide antibiotic. In a clinical study, it provided good symptom control in combination with paromomycin.

Clofazimine (Lamprene)

This is an orally administered medication. It is the only FDA-approved drug for the treatment of leprosy and is used off-label to treat non-tuberculous Mycobacteria. Clofazimine accumulates within the epithelial cells of the intestine, acting as a potential target for Cryptosporidium.


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