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Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
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Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
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Diarrhea is characterized by the occurrence of frequent, watery bowel movements. Various factors can trigger diarrhea, including viral or bacterial infections, foodborne illnesses, side effects from certain medications, and underlying digestive disorders. If not adequately managed, diarrhea can lead to complications such as dehydration, electrolyte imbalances, and nutrient deficiencies. Severe diarrhea can lead to significant weight loss, malnutrition, and weakened immune function.
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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Nitroimidazole-refractory giardiasis: a growing problem requiring rational solutions.

E R Carter1, L E Nabarro1, L Hedley2

  • 1The Hospital for Tropical Diseases, UK.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|June 19, 2017
PubMed
Summary

Treatment for Giardia intestinalis is becoming less effective due to drug resistance. New strategies and combination therapies are needed for refractory giardiasis cases.

Keywords:
AlbendazoleCombination treatmentGiardiaGiardiasisMepacrineMetronidazoleNitroimidazoleRefractorilyResistance

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Area of Science:

  • Infectious Diseases
  • Parasitology
  • Pharmacology

Background:

  • Giardia intestinalis, a common cause of diarrhea, is increasingly resistant to standard nitroimidazole treatments.
  • Treatment failures are prevalent, especially in travelers returning from Asia, necessitating alternative therapies.
  • Clinicians are exploring second-line and less common drugs due to rising refractory cases.

Purpose of the Study:

  • To review nitroimidazole-refractory Giardia intestinalis infections.
  • To examine the efficacy of current treatments and potential resistance mechanisms.
  • To outline practical management strategies for this emerging clinical challenge.

Main Methods:

  • A comprehensive PubMed search was performed using keywords related to Giardia resistance and treatment.
  • Articles focusing on pharmacotherapy, drug resistance, and alternative agents for refractory giardiasis were reviewed.
  • Existing data on standard and alternative drug efficacy, including in vitro and in vivo resistance, were assessed.

Main Results:

  • Standard nitroimidazole treatments show declining efficacy against Giardia intestinalis.
  • Alternative drugs are being used, but optimal strategies for refractory infections are not yet established.
  • Combination treatment approaches show potential advantages in managing resistant cases.

Conclusions:

  • There is currently no standard treatment regimen for nitroimidazole-refractory giardiasis.
  • Further research into drug resistance mechanisms is a priority.
  • Investigating drug combinations is essential for developing effective treatment strategies for refractory giardiasis.