[Nitazoxanide vs albendazole against intestinal parasites in a single dose and for three days]

To assess the effectiveness of the usual dose of nitazoxanide administered for three days and as a single dose for massive eradication of intestinal parasites in the pediatric population, compared with single-dose albendazole.

A randomized clinical trial was conducted in three rural communities in central Mexico City between 2001 and 2003 to assess three possible therapy regimes in a study population of 786 children 5 to 11 years of age, 92 of whom had a positive parasitology test result (15.1%). Group 1 included 27 patients treated with 400 mg given as a single dose of albendazole; group 2 included 34 patients whose therapy consisted of a 15 mg/kg/day dose for three consecutive days; patients in group 3 (n=31) were administered a single 1.2 g dose of nitazoxanide. Differences in proportions were assessed using Fisher's exact test.

No statistically significant differences were found in the effectiveness of the three treatment regimes: 80.5% with albendazole, compared with the two nitazoxanide alternatives (67.6% and 71%, respectively.A higher prevalence of side effects was observed with nitazoxanide in the three-day regimen (26.5%) and as a single dose (32.2%), compared with a single dose of albendazole (7.4%).

According to the evidence on effectiveness and side effects, the use of nitazoxanide is not justified as a massive prophylactic medication for intestinal parasitosis control alternative in endemic areas. In countries with a high prevalence of intestinal parasitosis primary prevention measures should be the most important strategy, together with public sanitation, drinking water and sewage system availability, water chlorination, and appropriate animal fecal waste disposal, as well as health education.