Treatment Options for the Eradication of Intestinal Protozoa

Authors and Disclosures

Michael JG Farthing, MJG Farthing is Professor of Medicine at St George's, University of London,London, UK

Competing Interests: The author has been involved in clinical trials of albendazole and nitazoxanide, and has received research funding for these trials from SmithKline Beecham Pharmaceuticals and Romark Pharmaceuticals.

Sidebar: Key points

• Intestinal protozoa cause clinically significant infections in both the developed and developing worlds, particularly in individuals with impaired cell-mediated immunity
  
  

• The clinical impact of infection with intracellular intestinal protozoa (Cryptosporidium, Microsporidia, Cyclospora, Isospora) in HIV-positive patients has been dramatically reduced following the introduction of highly active antiretroviral therapy (i.e. triple drug regimens)
  
  

• Cryptosporidiosis was a major clinical challenge, but can now be effectively treated with nitazoxanide (a substituted benzamide); treatment with nitazoxanide is also effective and safe in children
  
  

• Infection with the relatively new pathogen Cyclospora (like Isospora infection) can be cleared with co-trimoxazole
  
  

• Microsporidiosis remains a therapeutic challenge, but clinical trials indicate that albendazole and fumagillin are effective therapeutic options, although clearance is not consistently achieved