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Nitazoxanide: a new broad spectrum antiparasitic agent
1American College of Physicians and Infectious Disease Section, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, 535EA Houston, TX 77030, USA. arthurw@bcm.tmc.edu.
Expert Review of Anti-Infective Therapy
|October 16, 2004
Summary
Nitazoxanide is effective against various parasites like Cryptosporidium and Giardia, with fewer side effects than metronidazole. While effective for intestinal helminths, its efficacy is limited in advanced AIDS patients.
Area of Science:
- Pharmacology
- Infectious Diseases
- Tropical Medicine
Background:
- Nitazoxanide, derived from niclosamide, exhibits broad-spectrum in vitro activity against parasites and bacteria.
- Previous research indicated potential in treating parasitic infections.
Purpose of the Study:
- To evaluate the efficacy and safety of nitazoxanide in treating various parasitic infections.
- To compare nitazoxanide with existing treatments, such as metronidazole.
Main Methods:
- In vitro studies assessed antimicrobial and antiparasitic activity.
- Controlled clinical trials were conducted to evaluate efficacy in cryptosporidiosis and giardiasis.
- Clinical trials also assessed efficacy against intestinal helminths and in chronic fascioliasis.
Main Results:
- Nitazoxanide demonstrated efficacy in cryptosporidiosis, though limited in advanced AIDS patients (CD4 < 50).
- Efficacy in giardiasis was comparable to metronidazole, with a better side effect profile.
- The drug proved effective against intestinal helminths, tapeworms, and chronic fascioliasis.
- Observed side effects were similar to placebo.
Conclusions:
- Nitazoxanide is the first proven agent for cryptosporidiosis and shows proven efficacy in giardiasis.
- It is also efficacious against intestinal helminths.
- Further indications for nitazoxanide may emerge with future research.