The quality of evidence is downgraded by study quality (several issues).
A Cochrane review [Abstract] 1 included 19 studies with a total of 1817 subjects. 1441 participants were children. Most trials reported parasitological outcomes rather than clinical improvement.
Ten trials compared albendazole (400 mg once daily for five to 10 days) with metronidazole (250 mg to 500 mg three times daily for five to 10 days). This once-daily regimen of albendazole was equivalent to metronidazole at achieving parasitological cure and improving symptoms, but the duration of follow-up was short (two to three weeks). Albendazole had fewer side effects than metronidazole.
| Outcomes | Metronidazole(three times daily for 5 to 10 days) | Albendazole(once daily for 5 to 10 days) | Relative effect(95% CI) | No of participants(studies) |
| Parasitological cure | 91 per 100 | 90 per 100 | RR 0.99(0.95 to 1.03) | 932(10 studies) |
| Clinical improvement | 91 per 100 | 89 per 100 | RR 0.98(0.93 to 1.04) | 483(5 studies) |
| Gastrointestinal side effects | 29 per 100 | 8 per 100 | RR 0.29(0.13 to 0.63) | 717(8 studies) |
| Neurological side effects | 15 per 100 | 5 per 100 | RR 0.34(0.18 to 0.64) | 453(5 studies) |
Five trials compared mebendazole (200 mg three times daily for five to 10 days) with metronidazole 5 mg/kg (or 250 mg) three times daily for five to 10 days. No reliable conclusions on the relative effectiveness could be made.Five further trials evaluated shortened regimens of tinidazole (single dose; 179 participants, three trials), metronidazole (single dose; 55 participants, one trial), and nitazoxanide (three days; 55 participants, one trial). They could not reliably detect or exclude important differences.
Date of latest search: 2011-07-30
Primary/Secondary Keywords