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Intestinal giardiasis in children: Five years' experience in a reference unit.

M F Ara-Montojo1, J Bustamante2, T Sainz3

  • 1Paediatric Tropical and Infectious Diseases, Department of Paediatrics, La Paz University Hospital, Madrid, Spain.

Travel Medicine and Infectious Disease
|May 21, 2021
PubMed
Summary
This summary is machine-generated.

Giardiasis treatment failure is common in children, particularly those under two. Higher metronidazole doses improve success, and quinacrine is an effective second-line option for persistent giardiasis.

Keywords:
ChildrenGiardia intestinalisGiardiasisIntestinal parasitesMetronidazoleQuinacrine

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Area of Science:

  • Pediatric infectious diseases
  • Gastroenterology
  • Parasitology

Background:

  • Giardiasis is a common childhood infection, often with mild symptoms.
  • Metronidazole is the standard first-line treatment, but its efficacy can be limited.
  • Treatment failures necessitate exploring alternative strategies and identifying risk factors.

Purpose of the Study:

  • To identify risk factors for treatment failure in pediatric giardiasis.
  • To evaluate the safety and effectiveness of alternative treatment strategies.
  • To analyze treatment outcomes in a cohort of children with giardiasis.

Main Methods:

  • Retrospective observational study of children diagnosed with giardiasis (2014-2019).
  • Diagnosis confirmed via microscopy, antigen detection, and/or PCR stool analysis.
  • Treatment failure defined as persistent Giardia detection 4 weeks post-therapy.

Main Results:

  • First-line metronidazole treatment failure occurred in 20% of cases; a higher dose reduced failure to 8.3%.
  • Children under 2 years old had a significantly higher risk of treatment failure (OR 3.49).
  • Quinacrine demonstrated 100% effectiveness in 10 patients treated as a second-line option.

Conclusions:

  • Treatment failure in pediatric giardiasis is frequent, especially in children younger than 2 years.
  • Quinacrine shows promise as an effective second-line treatment for refractory giardiasis.
  • Confirmation of parasite eradication after treatment is recommended.