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Evidence summaries

Drugs for Treating Giardiasis

Albendazole may be equivalent to metronidazole at achieving parasitological cure in giardiasis, but albendazole may have less side effects. There is insufficient evidence to make conclusions between mebendazole and metronidazole or tinidazole and metronidazole. Level of evidence: "C"

The quality of evidence is downgraded by study quality (several issues).

Summary

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.

OutcomesMetronidazole(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 cure91 per 10090 per 100RR 0.99(0.95 to 1.03)932(10 studies)
Clinical improvement91 per 10089 per 100RR 0.98(0.93 to 1.04)483(5 studies)
Gastrointestinal side effects29 per 1008 per 100RR 0.29(0.13 to 0.63)717(8 studies)
Neurological side effects15 per 1005 per 100RR 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.

Clinical comments

Note

Date of latest search: 2011-07-30

References

  • Granados CE, Reveiz L, Uribe LG et al. Drugs for treating giardiasis. Cochrane Database Syst Rev 2012;12():CD007787. [PubMed]

Primary/Secondary Keywords