A randomised multicentre study to compare the safety and efficacy of albendazole and metronidazole in the treatment of giardiasis in children. [Randomized study comparing the safety and efficacy of albendazole and metronidazole in the treatment of giardiasis in children]. Albendazole versus metronidazole in the treatment of patients with giardiasis in the Islamic Republic of Iran. A comparative clinical trial of albendazole versus metronidazole in children with giardiasis. Albendazole versus metronidazole treatment of adult giardiasis: An open randomized clinical study. Albendazole as an alternative therapeutic agent for childhood giardiasis in Turkey. Albendazole versus metronidazole in the treatment of adult giardiasis: a randomized, double-blind, clinical trial. Albendazole as a treatment for infections with Giardia duodenalis in children in Bangladesh. Alternative treatment protocols in giardiasis: a pilot study. [COMPARATIVE STUDY OF ALBENDAZOLE VERSUS NITROFURANS AND NITROIMIDAZOLES IN THE TREATMENT OF GIARDIASIS IN CHILDREN] Tolerance and efficacy of combined diethylcarbamazine and albendazole for treatment of Wuchereria bancrofti and intestinal helminth infections in Haitian children. Tolerability and efficacy of single dose albendazole, diethylcarbamazine citrate (DEC) or co-administration of albendazole with DEC in the clearance of Wuchereria bancrofti in asymptomatic microfilaraemic volunteers in Pondicherry, South India: a hospital-based study. Randomized clinical study of nitazoxanide compared to metronidazole in the treatment of symptomatic giardiasis in children from Northern Peru. Double-blind placebo-controlled study of concurrent administration of albendazole and praziquantel in schoolchildren with schistosomiasis and geohelminths. Periodic deworming with albendazole and its impact on growth status and diarrhoeal incidence among children in an urban slum of India.
A randomised control multicentre study to compare the safety and efficacy of albendazole and metronidazole in the treatment of giardiasis in children is reported. One hundred and fifty children of either sex (age range: 2-10 years) were randomised to receive either a single dose of 400 mg of albendazole suspension, or 22.5 mg/kg/day of metronidazole in 3 divided doses for 5 consecutive days. At the end of therapy, majority of children in both treatment groups were symptom free. Two days after completion of therapy, 97% of children in both treatment groups were giardia free in the stools. Side effects were noted in 3 children in the albendazole group, and in 20 children in the metronidazole group. We conclude that albendazole suspension is as effective as metronidazole in the treatment of giardial infection in children. It is safe and has fewer side effects as compared to metronidazole. An open, randomized study was carried out with 100 children to compare the efficacy and security of albendazole and metronidazole to eradicate Giardia lamblia. We included 100 patients in primary school age with giardiasis confirmed by parasitoscopic test who had not received treatment during the 2 previous months. A complete clinical study was performed. By using an aleatory code, the children were distributed in 2 groups: A and B. The clinical data was corroborated and the following tests were made: cell blood count, blood chemistry, direct and concentrated coproparasitoscopic study. Both groups were given an antiparasite treatment consisting of albendazole for group A or metronidazole for group B. Clinical, parasitological and blood controls were conducted before, during and after the treatment. A therapeutic efficacy of 94% and 98% for group A and B, respectively, was found. We concluded that albendazole and metronidazole are equally effective in a 5 days treatment period, but some undesirable effects may occur with metronidazole. We examined the therapeutic effects of albendazole compared to metronidazole in 120 patients with giardiasis in Hamdan. Patients were randomized to receive albendazole (400 mg, once daily for 5 days) or metronidazole (250 mg, 3 times a day for 5 days). Demographic data of the patients, results of stool examination for Giardia trophozoites before and after treatment, and drug side-effects were recorded. After treatment 6 (10.0%) of the albendazole group had trophozoites compared with 14 (23.3%) of metronidazole group (P < 0.05). Patients in the albendazole group had fewer side-effects while 43.3% of the metronidazole group experienced a metallic taste and 35.0% experienced loss of appetite. Albendazole is an easy, safe and effective treatment for giardiasis. The adverse effects and treatment failures to some of the currently recommended drugs for giardia infection have given rise to the need for alternative antigiardial agents. In an open, randomized parallel group study, the safety and efficacy of albendazole was compared with metronidazole for the treatment of giardiasis in children. Sixty four children of age ranging from 2-12 years was randomized to receive either albendazole suspension 400 mg daily for 5 days or metronidazole suspension 400 mg daily for 5 days or metronidazole suspension 7.5 mg/Kg thrice daily for 5 days. The mean days required for cure, as evident by absence of cysts and/or trophozoites in the stool specimen, were 3.7 +/- 1.4 and 4.5 +/- 1.1 days, respectively for children on albendazole and metronidazole therapy. Six children on metronidazole therapy developed anorexia 2 to 4 days after the treatment. Albendazole proved as effective as metronidazole in the treatment of giardia infection in children with the added advantage of the absence of anorexia. To investigate the efficacy and tolerability of albendazole and metranidazole treatment in giardiasis.
                The open comparative randomized trial was carried out prospectively from December 1999 to July 2001 in Duzce City of Turkey. The diagnosis was based on the presence of signs and symptoms compatible with giardiasis including a positive stool examination of giardia cysts or trophozoite. Metranidazole group consisted of 29 patients and was given metranidazole 500 mg, three times a day for 5 d and albendazole group was consisted of 28 patients and was given albendazole 400 mg/d for 5 d.
                There were no significant differences in demographical and therapeutical effects and patient's compliance between both groups. But side effects were seen more in metranidazole group than in albendazole group.
                Albendazole is as effective as metranidazole in adults' giardiasis. Albendazole has less side effect potentials than metranidazole in the treatment of giardiasis. The efficacy of albendazole for the treatment of giardiasis has been indicated by previous in-vitro and in-vivo studies. In order to compare the therapeutic efficacy of albendazole and metronidazole, 107 Giardia-positive children (aged 3-15 years), diagnosed by three consecutive positive stool examinations, were enrolled in the study. Of these children, 52 were given a single daily dose of albendazole 10 mg/kg for 5 days, and 55 were given metronidazole 20 mg/kg daily in three doses for 7 days. Parasite eradication was achieved in 47 (90.4%) of 52 children treated with albendazole and 49 (89.1%) of 55 children treated with metronidazole (p > 0.05). These results suggest that albendazole is an effective treatment option for childhood giardiasis. Albendazole (ABZ) is a benzimidazole carbamate compound currently in use for human medical practice against enterobiasis and soil-transmitted helminthiasis (STH); However, its spectrum of activity is broad and goes beyond these infections.
                This study compares the efficacy and safety of ABZ versus metronidazole (MTZ) in human giardiasis.
                A randomized, double-blind, clinical trial was carried out at the Centre of Hygiene, Epidemiology and Microbiology in Matanzas City, Cuba. Adult patients with confirmed symptomatic G. duodenalis mono-infection were randomly assigned to receive either ABZ [400 mg daily (n = 75)] or MTZ [250 mg t.i.d. (n = 75)], both for 5 days. Follow-up fecal samples were obtained at 3, 5, 7 days after treatment end.
                The efficacy was similar for both treatment groups: ABZ (82.6%) and MTZ (85.3%); p > 0.05. Side-effects including bitter taste, headache, vomiting and dizziness were significantly higher in the MTZ group. Abdominal pain was significantly higher in ABZ group.
                ABZ was found as effective as MTZ in the treatment of G. duodenalis infections in adult patients from Cuba and could be a useful drug in areas where co-infection with STH infections is common. Albendazole, a broad spectrum anthelmintic recently shown to be active in vitro against Giardia duodenalis, was given at 4 different dosages and compared with metronidazole in the treatment of children in Bangladesh infected with Giardia. Three stools were collected over 10 d after treatment and examined microscopically. Albendazole was found to be effective: single doses of either 600 mg (n = 103) or 800 mg (n = 114) successfully treated 62% and 75% of infections, respectively; 400 mg given either once a day for 3 d (n = 116) or for 5 d (n = 115) successfully treated 81% and 95% of all infections, respectively. Albendazole given daily at 400 mg for 5 d was as effective as metronidazole, which cured 97% of infections (n = 230). Albendazole may thus be an alternative treatment for infections with Giardia, while the moderate efficacy of single doses may provide a benefit in addition to its effects on several species of intestinal helminths. The aim of the study was to test new treatment protocols for giardiasis, which are less toxic, cheaper, and easier to use than the conventional treatment. 48 children who had been diagnosed as having giardiasis in a health-screening program involving 2 schools, were randomized to receive four different treatment protocols. The children were split into 4 treatment groups: I, mebendazole 100 mg t.i.d. for 1 day; II, mebendazole 100 mg t.i.d. for 7 days; III, metronidazole 15 mg/kg as one dose for 7 days; and IV, ornidazole 40 mg/kg as a single dose. The results were evaluated by microscopic examination of stools. The responses to the treatments revealed that the effectiveness of ornidazole was 100%, metronidazole 92.9%, mebendazole for 7 days 58.3%, and mebendazole for 1 day 41.7%. Minor side-effects were seen in only 3 children receiving ornidazole: 1 had urticaria, while the other 2 suffered from vertigo and nausea. The results of this study show that ornidazole as a single dose can be used as an alternative protocol for treating giardiasis. Further studies should be done to determine the safest effective total single dose. A prospective, longitudinal, comparative, open and aleatory study in Jaen (Cajamarca--Peru), was performed during November 1997 and January of 1998. The objective was to demonstrate the efficacy and tolerance of Albendazol compared with Metronidazol, Furazolidona, Tinidazol and Secnidazol in the treatment of giardiasis in children. 79 children with giardiasis, confirmed by parasitologic studies were evaluated and distributed randorrily for aleatory code in A,B,C,D and E groups. The A group received Albendazol (5 days), the B group Metronidazol (10 days), the C group Furazolidona (10 days), the D group Tinidazol (1 d a) and the E group Secnidazol (1 d a); Clinical controls and coproparasitologic studies were performad during and after the treatment. The cl nical efficacy in the groups was of 100% and the efficacy coproparas tological of 94.1% with Albendazol, 93.3% with Secnidazol and 100% with Metronidazol. Furazolidona and Tinidazol. The global efficacy was excel lent with Al bendazol in 64,7% and in less than 40% with the other drugs, being the biggest pharmacological tolerance with Albendazol (82,3%) and Secnidazol (80%). We conclude that Albendazol is as effective as Metronidazol, Furazolidona, Tinidazol and Secnidazol but faster in eradicating the Giardia lambila in children and with better tolerance that Metronidazol, Furazolidona and Tinidazol. We consider necessary to control Epidemiological factor associated, to eradicate the parasite permanently. This randomized, placebo-controlled trial investigated the tolerance, efficacy, and nutritional benefit of combining chemotherapeutic treatment of intestinal helminths and lymphatic filariasis. Children were infected with Ascaris (30.7%), Trichuris (53.4%), and hookworm (9.7%) with 69.9% having more than one of these parasites. A total of 15.8% of the children had Wuchereria bancrofti microfilariae. Children were randomly assigned treatment with placebo, albendazole (ALB), diethylcarbamazine (DEC), or combined therapy. The combination of DEC/ALB reduced microfilarial density compared with placebo, ALB, or DEC (P < or = 0.03). Albendazole and DEC/ALB reduced the prevalence of Ascaris, Trichuris, and hookworm more than placebo or DEC (P < or = 0.03). Among Trichuris-infected children, those receiving ALB and DEC/ALB demonstrated greater gains in weight compared with placebo (P < or = 0.05). Albendazole and DEC/ALB were equally efficacious in treating intestinal helminths and for children with W. bancrofti microfilaremia, DEC/ALB was more effective than DEC, with no increase in severity of adverse reactions. BACKGROUND: The tolerability and efficacy of single dose albendazole (400 mg), diethylcarbamazine citrate (DEC) (6 mg/kg bodyweight) or co-administration of albendazole (400 mg) + DEC (6 mg/kg bodyweight) was studied in 54 asymptomatic Wuchereria bancrofti microfilaraemic volunteers in a double blind hospital-based clinical study. RESULTS: There was no significant difference in the overall incidence of adverse reactions between the three drug groups [42.1% (albendazole), 52.9% (DEC) and 61.1% (albendazole + DEC); P > 0.05]. The mean score of adverse reaction intensity did not differ significantly between the DEC and albendazole + DEC groups. However, the values in these two groups were significantly higher compared to that of albendazole alone [1.8 +/- 3.0 (albendazole) vs. 5.6 +/- 7.1 (DEC), 6.7 +/- 6.6 (albendazole + DEC); P < 0.05]. By day 360 post-therapy there was no significant difference between the three drug groups in relation to the clearance of microfilaria [26.3% (albendazole), 17.6% (DEC), 27.8% (albendazole + DEC)], reduction in geometric mean parasite density [94.7% (albendazole), 89.5% (DEC), 95.4% (albendazole + DEC)] or reduction in filarial antigenaemia [83% (albendazole), 87% (DEC), 75% (albendazole + DEC)]. Furthermore, there was a significant decrease in mean geometric parasite density (P < 0.05) as well as antigenaemia optical density values (P < 0.01) between pre-therapy levels and day 360 post-therapy in all three groups. CONCLUSIONS: This study has shown that single dose albendazole (400 mg) has similar efficacy in the clearance of microfilaria as that of DEC or the co-administration of the two drugs. The results strengthen the rationale of using albendazole for mass annual single dose administration for the control of transmission of lymphatic filariasis. Enteric infection by Giardia intestinalis is a common cause of diarrhoea world-wide and a significant cause of morbidity in children.
                To compare the efficacy and safety of nitazoxanide and metronidazole in the treatment of diarrhoea caused by G. intestinalis in children.
                A total of 110 children presenting with diarrhoea caused by G. intestinalis were randomized to treatment with either a 3-day course of nitazoxanide (100 mg b.d., age range 2-3 years; 200 mg b.d., age range 4-11 years) or a 5-day course of metronidazole (125 mg b.d., age range 2-5 years; 250 mg b.d., age range 6-11 years). The patients were followed-up for a determination of clinical response 7 days after the initiation of treatment, and two subsequent stool samples were collected for parasitological examination.
                Diarrhoea had resolved in 47 children out of 55 (85%) in the nitazoxanide treatment group before the day 7 follow-up visit, compared to 44 out of 55 (80%) for metronidazole. Diarrhoea resolved within 4 days in most cases. Only mild, transient adverse events were reported.
                A 3-day course of nitazoxanide suspension is as efficacious as a standard 5-day course of metronidazole suspension in treating giardiasis in children. A double-blind placebo-controlled study of the concurrent administration of albendazole and praziquantel was conducted in>1500 children with high prevalences of geohelminths and schistosomiasis. The study sites were in China and the Philippines, including 2 strains of Schistosoma japonicum, and 2 different regions of Kenya, 1 each with endemic Schistosoma mansoni or Schistosoma haematobium. Neither medication affected the cure rate of the other. There was no difference between the side effect rate from albendazole or the double placebo. Praziquantel-treated children had more nausea, abdominal pain, and headache but these side effects were statistically more common in children with schistosomiasis, suggesting a strong influence of dying parasites. The subjects were followed for 6 months for changes in infection status, growth parameters, hemoglobin, and schistosomiasis morbidity. In all 4 sites, a significant 6-month increase in serum hemoglobin was observed in children who received praziquantel, strongly supporting population-based mass treatment. This study was undertaken to measure the impact of periodic deworming with albendazole on growth status and incidence of diarrhoea in children aged 2-5 years in an urban setting in India and to assess the feasibility of local health workers implementing the procedures involved. This was a double-blind, placebo-controlled, randomized, community-based intervention trial with 702 children randomly allocated to receive either albendazole or placebo. The two study groups received two doses of albendazole (400 mg) or placebo six months apart. Mean weight increased significantly in the albendazole group compared to the control group at three months, six months and nine months following treatment (P<0.01, P<0.01 and P<0.001 respectively). The albendazole group also experienced fewer episodes of diarrhoea than their control counterparts (relative risk 1.3, 95% CI 1.07-1.53) with a 28% reduction. The health workers administered the correct dosage satisfactorily and there were no adverse effects. Thus, periodic mass deworming with albendazole would seem to be a safe and effective method that could be adopted at the community level or as an integral part of school health services and could be expected to improve growth and reduce the incidence of diarrhoea in children.
Albendazole may be of similar effectiveness to metronidazole, may have fewer side effects, and has the advantage of a simplified regimen. Large, high quality trials, assessing clinical outcomes (such as diarrhoea) will help assess further alternatives.